Underwriting guideGeneration Protector® Series

Long Term Care Insurance Policies

Allianz Life Insurance Company of North America

11-UG

Underwriting mission statement

To issue as many policies as possible while protecting the risk pool of the business.

Underwriting philosophyUnderwriting focuses on three main elements in the process of evaluating risk:

• Health status: What are the health impairments?

• Functionality: How well does the client get around, how active is she/he?

• Cognition: Is there evidence of memory problems?

An important aspect of underwriting is to recognize the impact of social support, social activities, and exercise tolerance on LTCi risk.

Underwriting strategies are directed at ascertaining the degree of severity, control and stability of medical conditions and the impact of those conditions on the individual’s health status, functionality, and cognitive abilities.

Information Hotline: 800.950.7372When to use the Information Hotline:

• To prequalifiy a client relative to health status and/or functionality

• To clarify interpretation of this underwriting guide with respect to individual client’s health

Hotline information7:00 a.m. – 6:00 p.m. Central time (Monday – Thursday)7:00 a.m. – 5:00 p.m. Central time (Friday)

Underwriting guidelines are subject to change. Please see the Web site at www.allianzlife.com for the most current version of the Underwriting Guide.

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Table of Contents

Premium rate class descriptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Previously-declined cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Underwriting requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Policy dating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Field selection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Prequalifying an applicant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Outcomes other than applied for, what to expect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Build chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Automatic decline list, uninsurable health conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Prescription drug guide, for uninsurable conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Impairment guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

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Premium rate classesLong term care insurance from Allianz offers five premium rate classes, noted below. To avoid difficulty in placing a policy with a higher premium than was originally quoted, pay special attention to health impairments and functionalitywhen quoting the rate class. Should your client qualify for a better rate than quoted, the appropriate (better risk) class will be issued.

The underwriting process takes into consideration the age of the individual, build, smoking status, the extent and severity, stability and instability of medical conditions, any comorbid conditions, as well as the functional and cognitive status,

in determining the rate class that is ultimately issued.

Preferred Plus (healthy, nonsmoking applicants)DO NOT SUBMIT AT PREFERRED PLUS RATE CLASS UNLESS ALL

OF THE FOLLOWING CONDITIONS ARE MET

• Nonsmoker for the last 24 months (other tobacco use acceptable)• Weight within Preferred Plus range on Build Chart• Consultation with a physician, to include a physical exam, within the last 18 months• No history of treatment for serious health conditions• Applicant may be receiving regular treatment of a preventative nature (see impairment section

of this guide for examples of individual health conditions)

Preferred (smokers or nonsmokers; stable health history) • Smoker in otherwise good health• Weight within Preferred range on the Build Chart• Medical history of health conditions which are well controlled and have an excellent prognosis

Standard (moderate health problems, well controlled, well managed, and stable)• Under treatment for a serious health condition that requires close medical supervision• History of a combination of mild to moderate conditions (comorbids)

Select I and Select II (well managed multiple health conditions, complex medical history, or recent changes in health status)• Medical conditions in combination with mild functional involvement• Multiple medical conditions of a moderate nature

Individual Consideration (IC)• Medical history does not fall within the parameters of the indiviual impairment as listed• Specifics on the application and medical history are evaluated by the underwriter based on the effect on

risk of the product• Cases approved after individual consideration are typically counter-offers used to offer some coverage while protecting

the risk to the Company

Previously-declined casesWe encourage agents to call the Information Hotline at 800.950.7372 to discuss previously-declined cases or any case thatinvolves complex medical history. As a general rule, we do not accept applications from individuals who have beendeclined by other LTCi companies.

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Underwriting requirement chartThe Underwriting Requirement Chart below indicates the requirements needed based on age and benefits. The HomeOffice will always take care of ordering all requirements, including the face-to-face interviews. The Home Office does allPhone History Interviews (PHIs). The Home Office will obtain medical records.

Underwriting specificsAny applicant age 65 through 71 who has not been seen by a physician within the past 24 months will not be

considered for coverage until he/she has completed a physical exam at his/her own expense; or until he/she has a face-to-face interview which will include a complete blood profile (BLDPF) and a Home Office urine specimen (HOS).

Any applicant age 72 through 84 who has not been seen by a physician within the last 24 months will not be considered for coverage until he/she has completed a physical exam1, at his/her own expense.

1The extent of the exam is minimally a ‘screening physical exam’ although the physician may have other requirements forsomeone not current on health maintenance. Allianz does not have a form for this purpose; documentation of clinicalinformation is the responsibility of the physician.

Additional requirements may be ordered at the discretion of the underwriter, based on the applicant’s health history.

Personal History Interview (PHI)

Telephone interviews will be ordered on all applicants age 69 and younger. Medical questions such as height, weight, orblood pressure would be examples of questions asked during telephone interviews. Specific questions related to activitiesof daily living (ADLs), such as “Do you have difficulty dressing?” will be asked on every interview. The interview may alsoinclude some cognitive test questions.

Face-to-Face Assessments (F/F)

Face-to-Face Assessments will be ordered through the Home Office on all applicants age 70 and older. On spousal applications where one applicant is age 70 or older and the second applicant is younger, this assessment will be done onboth applicants. The interview will include a detailed health history, blood pressure, height and weight, and a memory test. The Home Office pays for these assessments.

Attending Physician’s Statement (APS)

Medical records will be ordered on each applicant. The Home Office will order them. Primary care physician records are themost commonly required ones; occasionally specialist records are necessary for clinical detail on a particular condition.

Policy dating• When applicants are approved for coverage, a policy will be issued with an effective date that may range from

60 days prior to the application date (back-dating to save age) to 30 days after the underwriting approval date (post-dating to match the renewal date of the policy being replaced).

• Back-dating and post-dating must be requested on the application and will be accommodated if there are no concerns regarding the applicant’s health status.

• Current dating will not be required if it would change the issue age.

Ages 18-69 70-84PHI Required N/AF/F For specific conditions RequiredAPS Required Required

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Field selection• Eligible issue ages for Generation Protector IITM and Generation Protector SelectTM are 18-84 years, based on applicant

age at last birthday.

• The Build Chart in this guide will help to determine the proper rating class based on height and weight.

• The Prescription Drug Guide is a partial listing of certain medications that may indicate that a client has an uninsurablecondition. This guide may assist in determining the client’s impairments or insurability.

• The health conditions listed in the Impairment Guide section may assist in determining a client’s risk class andinsurability. If the client qualifies for a better risk class than applied for, the underwriter will issue the better risk class.

• Consider whether the applicant functions independently; and whether he/she requires assistance to walk.

• Consider whether the applicant is able to perform, without assistance, the activities of daily living (ADLs).1

• Consider whether the applicant has any difficulty with the instrumental activities of daily living (IADLs).2

• Determine whether the applicant is currently receiving disability or worker's compensation payments; this may indicatea current or recent history that typically excludes the applicant from insurability at the present time.

1ADLs include bathing, eating, dressing, toileting, continence, and transferring.

2IADLs include housekeeping, laundry, transportation, meal preparation, handling personal finances, taking medications, and using the telephone.

Inability to perform ADLs or IADLs may indicate a functional or cognitive limitation, which is not an acceptable risk.

Prequalifying questions to ask of the applicant:The answers to these questions are helpful in calling the hotline for a prequalifying question.

• Gender?

• Age?

• Height?

• Weight?

• Smoker?

• Medications?

• Non-prescription medications?

• Health conditions in the last five years?

• How long has the client had these health conditions and how long have these conditions been stable?

The underwriting process takes into consideration the age of the individual, the extent and severity of any healthcondition, stability and instability of health condition(s), the comorbid relationship of any conditions, as well as the

functional and cognitive status, in determining the rate class that is ultimately issued.

The information provided during the prequalifying process is carefully considered by the underwriter, along with the information developed during the PHI, F2F, and from medical records of the applicant’s physician.

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What to expect when the underwriting decision is other than applied for:

1) The underwriter will put a note on the Web site when the decision has been made.

2) The underwriter will include a clinical reason for a decision other-than-applied-for within the data privacyguidelines of HIPAA.

3) The underwriter will write a letter to the applicant with the decision other-than-applied-for, with a copy to the agent. The wording of this letter must also comply with data privacy regulations.

4) The underwriter will place a phone call to the agent with the decisions other-than-applied-for; a message will be left, if voicemail is available; a message will include the name and extension number of the underwriter.

5) The agent may call the underwriter for information to clarify the decision, if the wording of the above-mentioned communication is not clear.

6) The underwriter will reference the information that was disclosed by the applicant together with the underwriting guidelines on which the decision was made.

7) The underwriter will tell the agent if this is a permanent decline, or when a reapplication would be appropriate. NOTE: Reapplication is subject to full underwriting, and premium will be based on attained age.NOTE: A permanent decline stops any further underwriting processing at this point.

8) For the most positive outcome of ongoing discussions about the decision, it is recommended that the agent discuss the letter with the client.

9) The client is encouraged to speak to his/her physician about health conditions that are unknown to the client, as well as about dates of clinic visits mentioned in the letter.

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Build chartWeight

Height SI S P P+ P S SI SII IC

4' 7" 68–72 73–75 76–77 78–141 142–147 148–166 167–176 177-186 187–190

4' 8" 70–75 76–77 78–79 80–145 146–152 153–170 171–181 182-190 191–196

4' 9" 73–78 79–80 81–82 83–149 150–157 158–176 177–186 187-195 196–204

4' 10" 77–81 82–84 85–90 91–154 155–162 163–181 182–191 192-201 202–210

4' 11" 79–83 84–87 88–93 94–158 159–168 169–188 189–198 199-208 209–217

5' 0" 82–86 87–92 93–96 97–163 164–174 175–194 195–204 205-215 216–225

5' 1" 85–89 90–95 96–99 100–169 170–180 181–201 202–211 212-222 223–232

5' 2" 87–92 93–98 99–103 104–175 176–186 187–207 208–218 219-229 230–240

5' 3" 90–94 95–102 103–106 107–180 181–191 192–214 215–225 226-237 238–248

5' 4" 92–98 99–104 105–109 110–186 187–197 198–221 222–232 233-244 245–256

5' 5" 95–100 101–107 108–113 114–192 193–204 205–228 229–240 241-252 253–264

5' 6" 99–102 103–110 111–117 118–198 199–210 211–235 236–247 248-260 261–272

5' 7" 103–105 106–113 114–120 121–204 205–217 218–242 243–255 256-268 269–280

5' 8" 105–109 110–117 118–124 125–210 211–222 223–249 250–262 263-272 273–289

5' 9" 107–113 114–120 121–127 128–216 217–228 229–257 258–270 271-284 285–297

5' 10" 110–117 118–124 125–131 132–222 223–236 237–264 265–278 279-292 293–306

5' 11" 113–121 122–128 129–135 136–229 230–243 242–272 273–286 287-301 302–315

6' 0" 116–124 125–132 133–139 140–235 236–250 251–279 280–294 295-309 310–324

6' 1" 118–128 129–136 137–143 144–242 243–257 258–288 289–302 303-318 319–333

6' 2" 121–132 133–139 140–147 148–249 250–264 265–295 296–311 312-326 327–342

6' 3" 125–135 136–143 144–151 152–256 257–272 273–303 304–319 320-335 336–351

6' 4" 129–139 140–147 148–155 156–263 264–279 280–312 313–328 329-344 345–361

6' 5" 132–142 143–151 152–159 160–270 271–287 288–317 318–334 335-350 351–371

6' 6" 138–146 147–155 156–163 164–277 278–294 295–322 323–340 341-355 356–381

6' 7" 140–150 151–159 160–168 169–282 283–302 303–326 327–345 346-360 361–391

6' 8" 143–154 155–163 164–172 173–289 290–310 311–330 331–349 350-365 366–400

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Automatic decline listConditions listed below are uninsurable.

An application should not be submitted if an applicant has any of the following conditions.

Activity of daily living deficits, ADL

Adult day care services, current

AIDS, acquired immune deficiency syndrome

Alzheimer’s disease, memory loss, dementia

Ambulation difficulty, unsteadiness, instability, shuffling gait, use of assistive devices

Amyotrophic lateral sclerosis, ALS, Lou Gehrig’s disease, progressive neurological disease

Aplastic anemia, bone marrow failure syndrome

Arteriosclerosis obliterans, plaque formation of vessels to the extent of closure of blood vessels

Assisted living residence, current

Ataxia, lack of muscle coordination, due to a disorder in the brain

Brain impairments, disorders not identified elsewhere in this guide, most commonly damage as a result of trauma

Buerger’s disease; inflammation of the blood vessels, with subsequent clotting disorder

Cardiomyopathy, disease of heart muscle

Catheter use, urinary, daily or indwelling; a tube passed into the urinary bladder to allow the excretion of urine

CCRC living, current

Cirrhosis of the liver, gradual destruction of the ability of the liver to function

Claudication, pain in legs associated with poor circulation

Collagen disease, an autoimmune rheumatic disorder affecting tendons, bones, and tissues

Confusion, mental disorientation

CREST syndrome, slowly progressive systemic sclerosis

Creutzfeld-Jakob syndrome, a disease of the nervous system that causes dementia

Cystic fibrosis, congenital disease of the lungs

Defibrillator, implantable cardioverter defibrillator (ICD), device to control heart rhythm disorder

Dementia, memory impairment or loss, all types of cognitive deficits

Dermatomyositis, chronic weakness and inflammation of muscles

Dialysis, kidney/renal, the process of mechanically removing metabolic wastes from the blood

Disabled, and/or collecting disability or workers compensation benefits

Esophageal varices, chronic obstruction of blood flow of the esophagus related to liver function

Hemiplegia, paralysis of one side of the body

Hemophilia, blood clotting disorder

Hepatitis, chronic, active; inflammation of the liver; see impairment guide also

HIV positive; a blood test has indicated infection from the AIDS virus

Home care services, current or within the past 12 months

Hydrocephalus, abnormal accumulation of fluid in the brain

Huntington’s chorea, inherited disease of the nervous system

Implantable cardioverter defibrillator (ICD), device to control heart rhythm disorder

Intestinal angina, abdominal pain caused by narrowed blood vessels to the intestines

Kidney transplant, surgical implantation of donor kidney to replace one removed due to disease

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Lambert-Eaton syndrome, myasthenia gravis syndrome, a neurological disorder that causes weakened muscles.

Lupus, systemic lupus erythematous (SLE), chronic inflammation caused by autoimmune disease

Medicaid recipient

Memory loss, cognitive deficit, dementia

Mental retardation, disorder of below-average mental functioning

Multiple myeloma, cancer of white blood cells

Multiple sclerosis, inflammatory disease of central nervous system (brain and spinal cord)

Muscular dystrophy, congenital disease with progressive weakness and degeneration of muscle

Myelodysplasia, myelodysplastic syndrome, bone marrow disorder

Nephrosclerosis, hardening of kidney tissue

Nephrotic syndrome, progressive kidney damage with kidney failure

Nursing home confinement, current or recent

Obesity (as defined by weight above the top cut off of the Build Chart) frequently a comorbid with other conditions such asdiabetes, high blood pressure, heart disease, or arthritis

Organ transplant (except cornea – see Impairment Guide)

Organic brain syndrome (OBS), chronic disease or injury that interferes with brain function

Oxygen use, supplemental therapy to increase oxygen availability for the body

Parkinson’s disease, chronic progressive nervous disease with progressive muscle weakness

Pick’s disease, dementia that begins at an earlier age than senile dementia

Polycystic kidney disease, genetic disorder causing numerous cysts in kidneys leading to reduced kidney function and failure

Polycythemia vera, p. vera, excess of red blood cells involving bone marrow function

Pulmonary hypertension, high blood pressure in the arteries that supply the lungs

Quadriplegia, paralysis of all four limbs

Renal failure, renal insufficiency, kidney insufficiency or failure, gradual progressive loss of kidney function

Retinitis pigmentosa, gradual disintegration of eye function and progressive loss of vision

Retinopathy, diabetic, disturbance of vision secondary to the effects of diabetes

Schizophrenia, chronic, often debilitating mental illness

Scleroderma, progressive hardening and tightening of skin and connective tissues

Sclerosing cholangiitis, narrowing and hardening of bile ducts resulting in liver damage

Shunt (heart, brain, kidney), an artificial passage to divert fluids within the body

Shy-Drager syndrome, progressive disorder of nervous system

Social Security Disability Insurance recipient

Thromboangiitis obliterans (Buerger’s disease), inflammation of blood vessels with clotting

Transplant (except cornea – see Impairment Guide)

Waldenstrom’s disease or syndrome, bone marrow and blood disease

Walker use

Wheelchair use 9

Prescription drug guideDrugs prescribed for uninsurable conditionsIf the applicant is taking one of these drugs for the reason stated, he/she is not eligible for coverage. This list is a reference guide for prequalifying cases; it is not intended to be an exhaustive, all-inclusive list.

Alternate name for Condition for whichDrug name same drug drug is most commonly usedActimmune Interferon gamma 1-b Chronic granulomatous diseaseAbilify Aripiprazole SchizophreniaAkineton Biperiden Parkinson's diseaseAldazine Mellaril, Thioridazine Mental healthAmantadine Symmetrel Parkinson's diseaseAntabuse Disulfiram AlcoholismAranesp Darepeotinalfa Chronic anemia; renal failureAricept Donepezil DementiaArtane Novohexidyl Parkinson's diseaseAvonex Interferon, Rebif Multiple sclerosisAZT Retrovir, Apo-zidovudine HIVBendopa Levodopa Parkinson's diseaseBenztropine mesylate Cogentin Parkinson's diseaseBetaseron Interferon, Recombinant Multiple sclerosisBromocriptine Parlodel Parkinson's diseaseCarbidopa Sinemet Parkinson's diseaseChlorpormazine Thorazine Mental healthCladribine Leustatin Leukemia, multiple sclerosisClorazil Clozapine Mental healthClozapine Clorazil Mental healthCodeine Pain controlCogentin Apo-benztropine Parkinson's diseaseCognex Tacrine HCl DementiaCombivir Zidovudine, Lamivudine HIVComtan Entacapone Parkinson's diseaseCopaxone Glatiramer acetate Multiple sclerosisDantrium Dantrolene Multiple sclerosisDantrolene Dantrium Cerebral palsy, multiple sclerosisDarvocet Pain controlDemerol Pain controlDeprynel Eldepryl Dementia, Parkinson’s diseaseDilaudid Pain controlDonepezil Aricept DementiaDopar Levodopa Parkinson's diseaseDuragesic Pain controlEdrophonium Chloride Tensilon Myasthenia gravisEldepryl Selegiline Parkinson's diseaseEpogen Erythropoietin Renal failure, anemia of chronic diseaseEulexin Flutamide If for recurrent prostate cancerExelan DementiaFluphenazine Prolixin Mental healthFlutamide Eulexin CancerGlatiramer acetate Copaxone Multiple sclerosisHaldol Haloperidol Mental healthHydergine DHE45 DementiaInfergen Interferon alfacon-1 Hepatitis, other liver diseaseInsulin DiabetesInterferon Betaseron Multiple sclerosisIntron-A Interferon Cancer

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Invirase HIVKadian Morphine sulfate Narcotic pain controlLarodopa Levodopa Parkinson's diseaseLeukine Sargramostim, GM-CSF Bone marrow transplantsLeuprolide Lupron CancerLevodopa Carbidopa, Sinemet Parkinson's diseaseLorcet, Lortab Hydrocodone Pain controlLoxapine Loxitane Mental healthLupron Leuprolide If for recurrent prostate cancerMellaril Thioridazine Mental healthMestinon Edophonium Myasthenia gravisMethadone Dolophine Pain controlMirapex Pramipexide Parkinson's diseaseMoban Molindone Mental healthMorphine Narcotic pain controlMS-Contin Narcotic pain controlNaltrexone Alcohol abuseNamenda Memantine DementiaNarcotics, regular use Pain controlNavane Thiothixene Mental healthNeostigmine Prostigmin Myasthenia gravisNeumega Oprelvekin Severe blood diseaseNeupogen G-CSF, filgrastim Blood cell enhancer in

advanced diseaseNiloric DementiaNorgesic Pain controlNubain Pain controlOrap Pimozide Mental healthOxycodone Oxycontin, Proladone Pain controlParlodel Bromocriptine Parkinson's diseasePegasys Peginterferon alfa-2a Chronic hepatitis CPEG-Intron Peginterferon alfa-2a Chronic hepatitis CPercocet Pain controlPercodan Pain controlPergolide Permax, Celance Parkinson's diseasePermitil Prolixin Mental healthPerphenazine Trilafon Mental healthPimozide Orap Mental healthProcrit Erythropoietin Renal failure; anemia of chronic diseaseProlixin Fluphenazine Mental healthProstigmin Neostigmine Myasthenia gravisRebetron Hepatitis CRegonol Myasthenia gravisRevia Alcohol abuseRequip Parkinson's diseaseRetrovir HIVRilutek Riluzole ALSRisperdal Risperidone Mental healthRoferon-A Recombinant, rlFN-A AIDS, cancer, hepatitis, leukemiaRoxicet Pain controlSaquinavir HIV

Prescription drug guide (continued)Drugs prescribed for uninsurable conditionsIf the applicant is taking one of these drugs for the reason stated, he/she is not eligible for coverage. This list is a reference guide for prequalifying cases; it is not intended to be an exhaustive, all-inclusive list.

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Alternate name for Condition for whichDrug name same drug drug is most commonly used

Prescription drug guide (continued)Drugs prescribed for uninsurable conditionsIf the applicant is taking one of these drugs for the reason stated, he/she is not eligible for coverage. This list is a reference guide for prequalifying cases; it is not intended to be an exhaustive, all-inclusive list.

Selegiline Eldepryl Dementia, Parkinson’s diseaseSerentil, Serlect Mesoridazine Mental healthSeroquel Quetiapine Mental healthSinemet Carbidopa, Levodopa Parkinson's diseaseSparine Mental healthStadol Pain controlStelazine Trifluoperazine HCl Mental healthSymmetrel Amantadine Parkinson's diseaseSynapton DementiaTacrine DementiaTalwin Pentazocine Pain controlTaractan Mental healthTasmar Tolcapone Parkinson's diseaseTensilon Edrophonium Myasthenia gravisThioridazine Mellaril Mental healthThiothixene Navane Mental healthThorazine Chlorpromazine Mental healthTindal Mental healthTolcapone Tasmar Parkinson's diseaseTrichlorfon DementiaTrifluoperazine Stelazine Mental healthTrilafon Perphenazine Mental healthUltracet Pain controlZeldoz Mental healthZidovudine HIVZiprasidone Mental healthZyprexa Olanzapine Mental health

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Alternate name for Condition for whichDrug name same drug drug is most commonly used

Impairment guideIt is important to remember this is only a guide, and the final rate class will be determined by the underwriter,

based on all the facts of the case.

The risk class criteria indicated in this guide serve as general reference points.

The risk class criteria do not account for the age of the applicant or the impact of multiple disorders on one another.

The risk class criteria assume fully functional and intact cognitive status of the applicant, except if stated otherwise.

• The following is a list of medical conditions intended to provide a general idea of whether a client is insurable,and if so, whether she/he qualifies at Preferred Plus, Preferred, Standard, Select I, or Select II risk class.

• In general, the underwriter will postpone coverage in those cases in which major surgery has recently beencompleted or is pending.

• The waiting period for the specific condition needs to be met in order for coverage to be considered.

• Call the Underwriting Information Hotline at 800.950.7372 for any questions regarding a client’s insurability.P+ = Preferred Plus P = Preferred S = Standard IC = Individual ConsiderationSI = Select I SII = Select II NI = Not Insurable

AAblation, radio-frequency treatment to correct heart rhythm abnormality; refer to condition for which this procedure is done.Abscess, localized infection

P+ If locations other than brain and spinal cord, resolved and six months after treatment/surgery, without residual complications.

IC If involving brain or spinal cord, resolved without residual effects.NI Unresolved or < six months after treatment.

Acoustic neuroma, benign growth on the nerve from the brain to the inner earP+ 48 months’ stability; stable after treatment, no known residual tumor; no residual neurological symptoms.P 12 months’ stability after treatment; no known residual disease or symptoms.S 60 months’ stability; tumor present, unoperated, or residual tumor post-treatment; no symptoms; tumor size stable

on imaging.SI 36 months’ stability; present, unoperated; residual tumor post-treatment; no symptoms; tumor size stable on imaging.NI Any cognitive or functional impairment; related use of any assistive device; any progressive symptoms.

Addison’s disease, endocrine disorder of hormonal imbalanceP Controlled on medications, no complications, no other clinical conditions, after 24 months’ stability.IC With any other clinical conditions, any hospitalizations, after 24 months’ stability.NI All others.

ADL deficits, Activities of daily living deficits,NI Any mental or physical limitations in performing ADLs such as eating, transferring, bathing, dressing,

toileting, continence.Adult day care, community-based group programs designed to meet the needs of cognitively impaired adults

NI Attends adult day care.AIDS/HIV infection, chronic, life-threatening condition that destroys the cells of the immune system

NIAlcoholism, alcohol abuse, alcohol dependency, chronic progressive disease of impaired control over alcohol intake

P In recovery 60 months, good health, stable.S In recovery 36 months, good health, stable.SI In recovery 36 months, one related health condition, well controlled, stable.SII In recovery 36 months, more than one health condition all well controlled and stable.NI In recovery less than 36 months, or any relapses during recovery period, or continued drinking.

Alzheimer’s Disease, dementia, progressive memory impairmentNI

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Amaurosis fugax, painless, temporary loss of visionS Single episode, 60 months’ stability, no comorbid conditions.IC Single episode, after 36 months’ stability, no comorbid conditions.NI With smoking, or with atrial fibrillation, or with carotid stenosis > 50%.

Ambulation difficulty, unsteadiness, instability, imbalance, shuffling gait, need for assistive devices to walk or move aroundNI

Amnesia, transient global amnesia, partial loss of recall of events or experiencesP Single episode, after 24 months’ stability; no comorbids (see NI).S Single episode, after 12 months’ stability, no comorbids. SI Multiple episodes, after 36 months’ stability.NI With atrial fibrillation, or with carotid stenosis: 50%, or with any cognitive or functional impairment.

Amputation, loss of a limb or appendage; a face-to-face interview is likely to be orderedP Trauma cause, single extremity, independent in ADLs, stable 12 months.S Trauma cause, two extremities, independent in ADLs, stable 12 months.IC Others.NI Any amputation necessitated by or resulting from disease (e.g. diabetes, neurological, infection, or peripheral vascular

disease); any amputations that result in residual impairment of independent function, significant clinical depression, and/orinability to perform any ADLs or IADLs; amputation of more than two extremities; or any evidence of osteomyelitis or of non-healing stump; narcotics required for phantom limb pain on a regular basis.

Amyotrophic lateral sclerosis, (ALS), Lou Gehrig’s Disease, progressive neurological diseaseNI

Anemia, low level of red blood cells, low hemoglobinP+ Cause known, condition treated, resolved, mild, and stable 12 months; Hemoglobin (Hgb) > 13.P Cause known, condition treated, resolved, 6 months’ stability, Hgb > 12.S Cause known, condition treated, resolved, stable 6 months, Hgb 10 – 11.9.SI, SII Cause known, current treatment, Hgb 9 – 9.9, stable x 18 months.IC Others.NI Anemia that is severe, or unstable, or specific diagnosis of aplastic anemia; anemia that is poorly controlled due to conditions

of stomach or colon, or poorly controlled gynecological bleeding, or blood loss due to active malignancy.Aneurysm, abdominal aortic, weakening of major blood vessel in the abdomen

P Surgically corrected, stable 12 months.S Present < 4 cm size, well-controlled blood pressure, size monitored, stable 24 months.NI Present > 4 cm size.

Aneurysm, thoracic aortic, weakening of major blood vessel in the chestP Surgically repaired, stable 12 months, no residual cognitive or functional limitations.S Surgically repaired, stable 12 months, no cognitive impairment, mild functional residuals, fully independent.NI Present, un-operated, or with any residual cognitive impairment, or any need for assistance with ADLs/IADLs, any moderate

or severe functional impairment.Aneurysm, cerebral, weakening of blood vessel(s) within the brain

P Surgically treated, no residual effects, normal cognitive function, no other vascular diseases, stable 36 months.S Surgically treated, no residual effects, normal cognitive status, no other vascular diseases, 12 months’ stability.NI Present, or untreated, residual effects, cognitive loss, other vascular disorders.

Angina pectoris, chest pain related to the heartP Well-controlled with medications, with bypass surgery, or with angioplasty, or with stent, stable 6 months; no elevated

blood pressure, nonsmoker.S Well-controlled with medications, well-controlled mild hypertension, stable 6 months, nonsmoker.SI, SII Controlled with medications, controlled mild hypertension, non-smoker.IC Occasional symptoms or with history of myocardial infarction, heart attack, nonsmoker.NI Poorly-controlled symptoms, or with poor exercise tolerance, or smoker; with history of poorly controlled hypertension, heart

attack, TIA, stroke, diabetes, atrial fibrillation.Angioplasty, revascularization, repair of coronary arteries

P 6 months’ stability, successful procedure, no complications, nonsmoker, no elevated blood pressure, no heart attack, stable angina.

S 6 months’ stability, well controlled angina, nonsmoker, heart attack greater than 18 months ago, no other coronary surgeries.NI Poorly-controlled symptoms, or poor exercise tolerance, or smoker, or with history of poorly-controlled hypertension, or heart

attack within past 18 months; or with history of TIA, stroke, diabetes, atrial fibrillation, or heart failure.

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Anxiety disorder, excessive worry, may interfere with daily activitiesP+ Mild symptoms, no hospitalizations for this condition, no social or functional impairment; stable, no flare-up of symptoms or

medication changes in past 36 months; occasional medication (i.e. once/wk or less).P Mild symptoms, use of one medication on a regular basis ( > 3 x wk).S Moderate symptoms, daily medication use, no functional or social impairment, stable 60 months. SI Moderate symptoms, daily medication use, no functional or social impairment, stable 36 months.SII Moderate symptoms, regular use of medications, past history of hospitalization greater than 10 years ago; stable 36 months.NI Any degree of anxiety that impairs social or functional activity; hospitalization or ER visit(s) for this condition within past 10 yrs;

symptoms unstable, poorly-controlled.Aplastic anemia, failure of bone marrow to produce blood cells

IC Resolved, stable 12 months, off all treatment, normal lab values, related cause identified and resolved.NI Present, unresolved.

Arnold Chiari malformation, a disorder in which a portion of brain protrudes into the spinal canal P+ Asymptomatic, incidental finding, no cognitive limitations, no functional limitations. P Surgically treated, no residual cognitive or functional impairments, stable 12 months.S Surgically treated, no residual cognitive or functional impairments, stable 6 months.SI Current with mild, infrequent symptoms, occasional medications.SII Current with mild, occasional symptoms, regular medications. NI Currently symptomatic, surgery recommended or pending, and/or with any neurological or cognitive impairments.

Arteriosclerosis, thickening, hardening, or plaque formation in the arteriesP 6 months’ stability, without symptoms, diagnosed on examination; no comorbid conditions (see NI, below). S 12 months’ stability, with mild symptoms well-controlled, no comorbid conditions (see NI). NI With smoking, or with residual symptoms of peripheral arterial disease, post operative complications; with diabetes, heart

disease, atrial fibrillation, current skin ulcers, gangrene, other vascular disease, history of TIA, stroke, cognitive or functional limitations.

Arteriosclerosis obliterans, progressive plaque formation within arteries to the extent that the vessels are entirely blocked NI

Arteriovenous malformation, AV malformation, congenital malformation of arteries and veinsP 48 months’ stability after full surgical resection or coil embolization, no residual lesion, no symptoms.IC All others.NI Present, unoperated, with residual lesion.

Arthritis, degenerative arthritis, osteoarthritis, inflammation of joint(s)P+ Mild or minimal symptoms, or seen only on x-ray; no prescription medications for this for the past 36 months, no prednisone

or cortisone treatment at any time, no surgery done or recommended; no functional limitations, no joint injections.P Mild to moderate symptoms, regular use of nonprescription medications; no joint replacements, no functional limitations;

4 or fewer steroid or other joint injections in the past 24 months acceptable. S Moderate symptoms, 6 months’ stability; regular use of nonprescription medications acceptable, treatment with steroid and

other joint injections acceptable; no functional limitations; with one or more joint replacements.S1 Moderate symptoms, no physical limitations, no use of narcotics, treatment with injections acceptable after 6 months’

stability, prescription medications acceptable; multiple non-weight-bearing joint replacements.S2 Moderate symptoms, mild physical limitations, occasional use of narcotics; other prescription medications acceptable.NI With more than mild physical limitations, surgery anticipated, surgery completed within the past 6 months; regular narcotic

use; need for assistive devices.Arthritis, Rheumatoid arthritis, chronic inflammatory autoimmune disease, primarily of joints but can involve internal organs and tissues

P Mild, controlled with mild anti-inflammatories, stable 12 months, no functional limitations, no assistive devices.S Moderate, controlled with one medication, no steroid use, stable one year; no functional limitations, no assistive devices.SI, SII Moderate, controlled with multiple medications, history of one joint replacement stable 12 months; no functional

limitations, no assistive devices. NI Physical limitations, history of multiple joint replacements, or anticipated surgery, any functional limitations or

assistive devices.Assisted living, includes CCRC (continuous care retirement community)

NI Assisted living facilities offer help with ADLs such as eating, bathing, dressing, laundry, housekeeping, and assistance with medications. Many facilities also have centers for medical care; however, the care offered may not be as intensive or availableto residents as the care offered at a nursing home. Assisted living is not an alternative to a nursing home, but an intermediatelevel of long-term care.

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Asthma, inflammation of air passages of lungs and bronchial tubesP+ Mild, occasional medication use only, no Prednisone use, FEV1 >65%.P Mild, controlled with medications, no hospitalizations; inhaled steroids acceptable, stable 24 months without flare-ups,

past smoker > 24 months ago.S Mild to moderate; < 4 attacks/yr, no hospitalizations, stable 24 months, with or without smoking; FEV1 50 – 65%.SII Moderate; with or without smoking; controlled with medication, oral steroids acceptable if within guidelines under ‘steroid use’

in this guide; with associated respiratory diseases such as COPD or bronchiectasis if FEV1 50 – 65% between attacks; inhaledsteroids acceptable; may have 1 or 2 short courses of oral steroids per year; no hospitalizations in past 24 months.

NI Severe disease, FEV1 < 50% between attacks; chronic daily use of steroids, associated unstable respiratory disease, history of hospitalization within the past 60 months.

Ataxia, lack of muscle coordination due to disorder in the brainNI

Atrial fibrillation, episodic, paroxysmal, recurrent rapid irregular heartbeatP One or two brief episodes in 36 months; no known underlying heart disease; mild hypertension and mild diabetes acceptable.S Brief episodes; no syncope; no ER visits, no hospitalizations; no diabetes, TIA, stroke, coronary artery disease, no heart valve

disease, no cardiomyopathy; no congestive heart failure; hypertension with excellent control is acceptable; 12 months stability, taking Coumadin with good compliance.

IC Others.NI Poorly-controlled, not treated with anticoagulant medication, or with 2 episodes per year, or with diabetes, heart attack, TIA,

stroke, CVA, with disease of heart valves, cardiomyopathy, or congestive heart failure.Atrial fibrillation, chronic, ongoing rapid irregular heartbeat

S Fibrillation controlled, with anticoagulant medications, without symptoms, syncope, other cardiovascular disease; stable 12 months, no hospitalizations or ER visits; no diabetes, TIA, stroke, coronary artery disease, no additional heart disease, hypertension under excellent control.

NI Poorly-controlled, or with diabetes, TIA, stroke, additional heart disease (especially valve disease, cardiomyopathy, congestiveheart failure).

Avascular necrosis, loss of blood supply to bones resulting in the collapse of bone tissueP Single bone, fully resolved with no functional limitations, 12 months’ stability.S Recurrent episodes, single bone involvement, no functional limitations, 12 months’ stability.NI Single or multiple episodes, or due to chronic illness, or with residual deficits .

AV malformation, arteriovenous malformation, congenital malformation of arteries and veinsP 48 months’ stability after full surgical resection or coil embolization, no residual lesion, no symptoms.IC All others.NI Present, unoperated; with residual lesion.

BBack disorder, symptoms relative to bones and associated structures of the spine

P+ No symptoms or medications for the past 36 months; no current physical therapy; no functional limitations.P Mild symptoms persistent but stable 6 months, no functional limitations, no disability, no assistive devices, regular use

nonprescription medications.S Current mild to moderate symptoms; or symptoms relative to herniated disc; no functional limitations; regular use of

prescription medication acceptable; no current narcotic use; see physical therapy guidelines.SI Compression fracture(s) on imaging study; no osteoporosis; mild to moderate symptoms, no narcotic use, minimal

functional limitations.SII Mild to moderate symptoms; multiple medications acceptable; occasional narcotic use (< 3 x wk); minimal functional

limitations.NI Severe symptoms, or disabling symptoms, any functional limitations, regular narcotic use, surgery recommended or planned,

or receiving work comp, or disability reimbursement.

Back pain, muscle strain of the back, symptoms of the back that do not involve bones and spinal structures; the underwriter willtake into account the circumstance of the onset of symptoms, the intensity and duration of the pain. If symptoms are related to a fall,it cannot be as a result of dizziness, imbalance, vertigo, or syncope; those conditions will be underwritten separately

P+ 6 –12 months’ stability, no symptoms currently, muscle strain only, with no neuroskeletal involvement, not related to falling, nofunctional limitations, no current treatment.

P 3 – 6 months’ stability; muscle strain only with no neuroskeletal involvement, not related to falls, no functional limitations, current treatment with OTC remedies only.

S Persistent mild-moderate muscle strain symptoms, stable with no neurological involvement, not related to falls; no functionallimitations, no current narcotic use; no use of Rx Neurontin; 6-12 months’ stability.

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SI Moderate symptoms with mild functional limitations; no need for assistive devices, no neurological involvement; 12 months’ stability.

NI Severe persistent symptoms, any neurological involvement, current narcotic use, more than mild functional limitations, use of Neurontin; need for assistive devices.

Barrett’s esophagus, cell changes in the lining of the esophagusP Good response to treatment, with stable follow-up endoscopies. S No endoscopy in the past 24 months .SI No endoscopy in the past 36 months.SII Chronic mild symptoms controlled with medication, negative biopsies, stable endoscopies.NI Poorly-controlled, or any dysplasia on biopsy.

Bell’s palsy, partial paralysis of facial nerveP+ Past history with complete recovery.P Residual facial weakness not disabling.

Benign prostatic hypertrophy, BPH, enlarged prostate glandP+ BPH present, minimal symptoms, unoperated, or surgery with good results, normal PSA, 3 months’ stability.P Mild to moderate symptoms, no surgery recommended or pending; normal PSA, 6 months’ stability; past surgery

with good results.NI BPH, severe symptoms, or surgery recommended or pending; abnormal prostate exam, not worked up, or work up

in progress, pending results of exam. See guidelines for PSA readings in this guide.

Bipolar, manic depression, mental illness of extreme mood swings which can be disablingS Well-controlled on medication; a single hospitalization more than 10 years ago acceptable; fully independent, no

cognitive or functional limitations; 48 months’ stability.SI 36 months’ stability, well-controlled on medication; a single hospitalization more than 10 years ago acceptable; fully

independent, no cognitive or functional limitations.SII 24 months’ stability; well-controlled on medication; a single hospitalization more than 10 years ago acceptable; fully

independent, no cognitive or functional limitations.NI Multiple psychiatric hospitalizations; any cognitive or functional impairment; multiple medication adjustments in past

48 months, hospitalization within the past 120 months.

Bladder disease, infection, infections of urinary bladderP+ < 4 per year, with complete recovery.P, S Chronic low grade infections without incontinence.NI Chronic infections; chronic incontinence.

Bladder prolapse, urinary bladder disorderP+ Mild to moderate with no symptoms; or post-surgery, released from surgeon’s care; no incontinence.IC Other.

Blood pressure, high or elevated, hypertension, abnormally high pressure in the arteriesP+ Mild, controlled at no greater than 140/90 average reading, without heart disease; without diabetes; stable 24 months.P Mild, controlled with average readings no greater than 140/90, nonsmoker, no heart disease, no diabetes; stable 12 months.S Mild, controlled, stable 12 months; without diabetes; with mild stable coronary disease, average readings no greater than 140/90.S Moderate, controlled without diabetes, without heart disease, stable 12 months, with average readings no greater than 145/95.SI Moderate, control with medication(s), average readings < 145/95, may be in combination with other cardiac conditions or

diabetes if all conditions well controlled; 6 months’ stability.SII Moderate, controlled with medication(s), average readings < 160/90, with any other conditions well controlled,

6 months’ stability.NI Poorly controlled with average readings greater than 160/95, or together with poorly controlled diabetes, severe coronary

artery disease, stroke, TIA, atrial fibrillation, heart valve disease.

Braces, external appliance to support joint movement, face-to-face assessment may be requiredSI, SII Used for weakness, not for paralysis, without ADL limitations; single brace of leg, foot, or ankle acceptable.NI With ADL limitations; with any other limb amputation.

Brain impairment, an abnormality of the function of the brain, may be cognitive or functional; most commonly a result of trauma

IC Post-injury that does not significantly interfere with cognition or function.NI Post-injury that continues to significantly interfere with brain function, cognition, or function.

Brain tumor, benign, an abnormal growth of tissue within the brainS Stable 60 months after treatment, no functional or cognitive limitations, follow-up imaging studies favorable.NI Present, unoperated; with cognitive or functional impairments, use of any assistive devices, and all others.

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Breast cancer, in situ, early stage, localized malignancy of the breastP 12 - 24 months’ stability; one or two limited areas, surgically treated; lymph nodes negative; no recurrence.S 36 months’ stability; extensive or recurrent disease, surgically treated; lymph nodes negative.IC Others; if any positive lymph nodes, rate as invasive breast cancer.

Breast cancer, invasive, malignancy of the breast that involved additional tissueP 96 months’ stability; surgically treated; lymph nodes negative, no recurrence, 90 day elimination period (EP).P 60 months’ stability; surgically treated; lymph nodes negative; no recurrence, 180 day EP.S 48 months’ stability; surgically treated; lymph nodes negative; no recurrence.SI 36 months’ stability; surgically treated; lymph nodes negative; no recurrence.SII 24 months’ stability; surgically treated; lymph nodes negative; no recurrence.IC Moderately large lesion; any with positive lymph nodes; with recurrence.NI Other.

Breast disorder, benign, a non-malignant abnormality of breast tissueP+ Fibrocystic disease, no surgery recommended or planned.

Bronchiectasis, chronic dilatation of the breathing tubes in the lower part of the lungsP, S Mild disease, non-smoker, 24 months without symptoms, no periods of disability, no respiratory therapy, normal PFTs,

controlled with non-steroidal medication. SI, SII Moderate disease, non-smoker, controlled with medications, no history of respiratory therapy or steroids in past 12 months,

FEV1 > 65%.NI Severe disease, frequent exacerbations, current steroid use, with smoking; FEV1 less than 50%.

Bronchitis, infection in the air passages of the lungsP+ Acute attacks only, < 4 x year, resolved without complications, no underlying chronic bronchitis or COPD.P > 4 attacks per year, without complications, mild well-controlled asthma, no underlying chronic bronchitis or COPD, occasional

short course of oral steroid use is acceptable.IC Chronic symptoms; all others.

Buerger’s disease, thromboangiitis obliterans, inflammation of blood vessels with clottingNI

Bypass surgery, coronary artery bypass grafting, CABGP 6 months’ stability; blood pressure well-controlled, no chest pain, or angina; no diabetes, heart attack, stroke, TIA, or atrial

fibrillation; nonsmoker.S 6 months’ stability, well-controlled with medications, well-controlled hypertension, nonsmoker; no heart attack, diabetes,

stroke, TIA, atrial fibrillation, angina stable.SI 6 months’ stability, former smoker, well-controlled with medications, well-controlled hypertension; no diabetes, stroke, TIA,

atrial fibrillation; angina stable; no heart attack > 24 months ago.NI Poorly controlled symptoms, or with poor exercise tolerance, or with smoking, poorly controlled hypertension, recent heart

attack, any TIA, stroke, diabetes, atrial fibrillation, or other heart condition.

CCancer (See impairment listings for specific type of cancer, if available; for other types of cancer, use this guide.) Cancer is an abnormal growth of malignant tissue

P 60 months’ stability; treated for cure, lymph nodes negative, no recurrence.S 36 months’ stability; treated for cure, lymph nodes negative, no recurrence.S 48 months’ stability; treated for cure, lymph notes positive, no recurrence.

Cancer of the breast, in situ, early stage, localized malignancy of the breastP 12 - 24 months’ stability; one or two limited areas, surgically treated; lymph nodes negative; no recurrence.S 36 months’ stability; extensive or recurrent disease, surgically treated, lymph nodes negative.IC Others; if any positive lymph nodes, rate as invasive breast cancer.

Cancer of the breast, invasive, malignancy of the breast that involved additional tissueP 96 months’ stability; surgically treated; lymph nodes negative; no recurrence, 90 day elimination period (EP).P 60 months’ stability; surgically treated; lymph nodes negative; no recurrence, 180 day EP.S 48 months’ stability; surgically treated; lymph nodes negative; no recurrence.SI 36 months’ stability; surgically treated; lymph nodes negative; no recurrence.SII 24 months’ stability; surgically treated; lymph nodes negative; no recurrence.IC Most moderately large lesions; cases with positive lymph nodes; any recurrence.NI Other.

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Cancer of the colon, malignancy of the intestineTumor staged as “in situ”:

P 24 months’ stability, good follow-up.S No period of stability, surgically removed.

Tumor stage Duke’s A:P 48 months’ stability.S 24 months’ stability.SI 12 months’ stability.

Tumor stage Duke’s B:P 60 months’ stability; surgically treated, negative lymph nodes; no recurrence.S, SI, SII 36 months’ stability; surgically treated, negative lymph nodes; no recurrence.

Tumor with positive lymph nodes:S 60 months’ stability; surgically treated; no recurrence.SI, SII 48 months’ stability; surgically treated; no recurrence.NI Others.

Cancer of the ovary, malignancy of the ovariesNegative lymph nodes, surgically treated, no recurrence:

P 60 months’ stability.S 36 months’ stability.

Positive lymph nodes, surgically treated, no recurrence:P 96 months’ stability.S 60 months’ stability.SI, SII 48 months’ stability.NI Others.

Cancer of the prostate, malignancy of the prostate glandGleason 2 - 5; tumor stage T1 or T2; no recurrence:

P 60 months’ stability, 90 day elimination period (EP).S 36 months’ stability, 90 day EP.SI 24 months’ stability, 180 day EP..SII 12 months’ stability, 180 day EP.

Gleason 6; tumor stage T1 or T2; no recurrence:P 60 months’ stability, 90 day EP.S 36 months’ stability, 180 day EP.

Gleason 7; tumor stage T1 or T2; no recurrence,S 60 months’ stability, 90 day EP.SI 36 months’ stability, if pre-treatment PSA less than 20, 180 day EP.IC Others, 48 months’ stability, 180 day EP.NI High stage/grade, hormone treatment (for example: Lupron, Eulixin).

Cancer of the skin, basal cell or squamous cell cancers, malignancy of skin P+ Up to 4 basal cell or squamous cell lesions removed, without complications.P+ Other recurrences, or moderate stage, or recurrence, none for 48 months.P Other recurrences, or moderate stage, none for 24 months.S Frequent recurrence, but none for 24 months.IC Others (for malignant melanoma, see below).

Cancer of the skin, malignant melanoma, serious type of skin cancerP Very early stage, completely removed, 48 months’ stability.S Very early stage, completely removed, 24 months’ stability.S With any recurrence; with any positive lymph node, 120 months’ stability.SI, SII Early stage, completely removed, 48 months’ stability.NI, IC With recurrence; with positive lymph nodes.

Cane use; the condition for which cane is used will be underwrittenIC Single-point, straight cane; face-to-face interview may be required; no falls; over the age of 60 when cane use began.NI Quad-cane, or four-point cane use, including occasional use; any falls or fractures.

Cardiomyopathy, disease of heart muscleIC Mild with minimal symptoms, stable 12 months.NI All others.

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Carotid artery disease, thickening, narrowing or plaque formation in arteries of the neckP Mild, < 50% stenosis, without symptoms, nonsmoker, stable 24 months from date of diagnosis, no conditions from the

“NI” list below.S Moderate, 51- 60% stenosis, nonsmoker, stable 24 months from time of diagnosis, no conditions from the “NI” list belowS1 Moderate, 61 - 69% stenosis, nonsmoker, if corrected with endarterectomy, stable 24 months from time of diagnosis, no

conditions from the “NI” list below.S2 Moderate with < 69 % stenosis, nonsmoker, with any other health conditions that are well-controlled, stable 24 months.NI Severe, 70% stenosis; or symptomatic with any degree stenosis, or with smoker currently or in the past 24 months, or with TIA

or stroke, or with diabetes, atrial fibrillation, heart valve disease (except MVP), heart attack, MI, angina, poorly controlled hypertension, embolism, or peripheral vascular disease.

Carpal tunnel syndrome, repetitive stress injury, restricted or painful movement of wrist P+ Mild symptoms, no functional limitations.P Mild symptoms, nonprescription medication use, no regular narcotic use, no functional limitations, no brace or wrist support.S Mild to moderate symptoms, minimal functional limitations, prescription medication use, no regular narcotic use, nighttime

wrist support only.SI Moderate symptoms, minimal functional limitations, prescription medication use, no regular narcotic use, daytime

wrist support.SII Severe current symptoms, increasing functional limitations.NI Any symptoms that cause functional limitations, current regular narcotic use, surgery recommended and not done,

or surgery scheduled.Cataract, clouding of the normally clear lens of the eye

P+ Present, but surgery not necessary; or surgery completed without complications.P Surgery pending on one eye; other eye already done, or has no significant visual impairment.SI Surgery pending, both eyes.

Catheter use; the need for a tube to be inserted into the urinary bladder to allow for excretion of urineNI

CCRC, continuous care retirement community residenceAssisted living facilities offer help with ADLs such as eating, bathing, dressing, laundry, housekeeping, and assistance with medications.Many facilities also have centers for medical care; however, the care offered may not be as intensive or available to residents as thecare offered at a nursing home. Assisted living is not an alternative to a nursing home, but an intermediate level of long-term care.

NICerebral palsy, congenital neurological disorder

SI, IC Mild disease, minimal ambulatory difficulty without braces; orthotics acceptable, no functional impairment, living independently.SII, IC Mild disease, minimal ambulatory difficulty with braces; orthotics acceptable; no functional impairment, living independently.NI All others.

Cerebral vascular accident, see “stroke”Charcot-Marie-Tooth disease, disorder of nerves of feet, legs, hands.

S 60 months’ stability; mild involvement of feet and legs only, no assistive devices or braces required.IC 24 months’ stability, ambulatory without assistance; no more than very slowly progressive.

Cholecystitis/cholelithiasis, gall bladder disease, inflammation of, or stones in the gallbladderP+ stones present, incidental finding, no symptoms; or after surgery with no complications, and 3 months’ stability. P 12 months’ stability, stones present, single flare of symptoms, no surgery done.S 24 months’ stability, 1 or 2 past episodes of symptoms, or with mild cholecystitis, stable with no current symptoms.IC All others.

Chronic fatigue syndrome, ongoing symptoms of persistent fatigue which may interfere with daily activities P History of condition, fully recovered, 24 months’ stability; no past or present limitations, no history of being on disability from

work or otherwise functionally impaired; no current treatment.S Mild symptoms, 24 months’ stability, treated with nonprescription medications, no past or present functional limitations.SI, SII Moderate symptoms, 24 months’ stability, use of prescription medications, no functional limitations, no narcotic use.NI Described as severe, or with past or present associated memory loss; or recent onset < 24 months; or regular use of narcotics,

any functional limitations.Chronic obstructive pulmonary disease (COPD), emphysema, persistent obstruction of the airways of the lungs

P Mild disease, nonsmoker; FEV1 greater than 65%.S Moderate disease, nonsmoker; FEV1 50 - 65%.IC Mild disease, continued smoking with FEV1 greater than 65%.NI Severe, or FEV1 less than 50%.

Cirrhosis, liver, gradual destruction of the ability of the liver to functionNI

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Claudication, pain in legs associated with poor circulationNI

Colitis, ulcerative, inflammatory bowel diseaseP+ Asymptomatic, or minimal symptoms, stable 24 months, no treatment, no medication, acceptable medical follow-up

(including colonoscopies), weight stable within guidelines for P+.P Status post total colectomy, no complications, no problems with ileostomy management, stable since surgery, no treatment or

medication, 24 months’ stability.S Minimal to moderate symptoms, controlled with one medication, acceptable medical follow-up (including colonoscopies),

weight stable, overall condition stable 24 months.SI 24 months’ stability, moderate symptoms, acceptable medical follow-up including colonoscopy, multiple medications,

no flares in stability period, weight stable.SII Moderate symptoms, acceptable medical follow-up including colonoscopies, multiple medications, no flares in past

12 months, weight stable.NI All others.

Collagen-vascular disease/mixed connective tissue diseasesAutoimmune rheumatic disorder with features similar to, and overlapping with, lupus, polymyositis, and scleroderma

NIColon cancer, malignancy of the intestineTumor staged as “in situ”:

P 24 months’ stability, good follow-up.S No period of stability, surgically removed.

Tumor stage Duke’s A:P 48 months’ stability.S 24 months’ stability.SI 12 months’ stability.

Tumor stage Duke’s B:P 60 months’ stability; surgically treated, negative lymph nodes; no recurrence.S, SI, SII 36 months’ stability; surgically treated, negative lymph nodes; no recurrence.

Tumor with positive lymph nodes:S 60 months’ stability; surgically treated; no recurrence.SI, SII 48 months’ stability; surgically treated; no recurrence.NI Others.

Colostomy, an opening of a portion of the bowel through the abdominal wall; reason for surgery will also be underwritten SI Stable 24 months post surgery. NI Complications, or lack of stability period.

Complex regional pain syndrome, reflex sympathetic dystrophy, causalgia, chronic pain due to traumatic nerve injuryP 12 months’ stability, fully resolved, no residuals. S 12 months’ stability, with nonprescription medications, no current physical therapy; or with 60 months’ stability, currently

symptomatic, controlled with prescription medications; no functional limitations.SI, SII Currently symptomatic, may be controlled with prescription medications, without functional limitations.NI Currently symptomatic or with current functional limitations, current physical therapy, current regular narcotic pain control.

Confusion, mental disorientationNI

Congestive heart failure, CHF, weakened ability of the heart muscle to pump blood P History of congestive heart failure, resolved and stable for 12 months, off heart medication.S 12 months’ stability, history of CHF, underlying heart problem fully investigated and treated successfully; ejection fraction of

greater than 45%.SI, SII Chronic or multiple episodes of congestive heart failure, stable 24 months, underlying heart problem stable with ejection

fraction greater than 45%.NI Others.

COPD, chronic obstructive pulmonary disease, emphysema, persistent obstruction of the airways of the lungsP Mild disease, nonsmoker; FEV1 greater than 65%.S Moderate disease, nonsmoker; FEV1 50 – 65%IC Mild disease, continued smoking with FEV1 greater than 65%NI Severe, or FEV1 less than 50%.

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Corneal transplant, replacement of diseased cornea of the eyeP One eye involved only; other eye with normal cornea; no significant visual impairment, 24 months’ stability.SI 24 months’ stability, both eyes involved without rejection, no complications. NI Others.

Coronary artery disease, coronary artery bypass graft surgery (CABG), surgical placement of a donor vessel, or shunt, to routeblood flow around a blockage in a vessel of the heart

P Mild, stable 6 months; blood pressure well-controlled, no chest pain, or angina; no diabetes, heart attack, stroke, TIA, or atrial fibrillation; nonsmoker.

S Mild, 6 months’ stability, well-controlled with medications, well-controlled mild hypertension; nonsmoker; no heart attack, diabetes, stroke, TIA, atrial fibrillation, angina stable.

S1 Moderate, 24 months’ stability, former smoker, well-controlled with medications, well-controlled hypertension, no diabetes,stroke, TIA, atrial fibrillation; angina stable; no heart attack > 24 months ago.

NI Poorly controlled symptoms, or with poor exercise tolerance, or with smoking, poorly controlled hypertension, recent heartattack, any TIA, stroke, diabetes, atrial fibrillation, or other heart condition.

CREST syndrome, slowly progressive systemic sclerosisNI

Creutzfeldt-Jakob syndrome, a form of dementiaNI

Crohn’s disease, inflammatory disease of small bowelP Stable 12 months, minimal or no symptoms, unoperated, no associated complications, no steroid treatment, weight stable.P 60 months’ stability since last flare, or since surgery; no current symptoms; no oral steroids or 6-mercaptopurine (Purinethol);

no more than one related surgery.S Stable 12 months or more since last flare, or since surgery, no symptoms, no current symptoms, no oral steroids or

6-mercaptopurine (Purinethol); no more than 1 related surgery.SI Mild symptoms, no oral steroids; 6-MP (Purinethol) is acceptable.SII Moderate symptoms, whether or not surgically treated previously, low dose steroid treatment and/or 6-MP

(Purinethol) acceptable.NI Less than 12 months since major flare, any complications, including fistula, malabsorption, weight loss, bowel obstruction,

significant abdominal pain, hospitalization in past year.Cushing’s syndrome, disorder of the adrenal glands

IC Caused by pituitary tumor or adrenal tumor, resolved after surgery; will be rated according to primary cause, underlying disease, and steroid use.

NI If caused by steroid use, and currently remains on steroids.CVA, see “stroke”Cystic fibrosis, congenital disease of the lungs

NI

DDefibrillator, implantable cardioverter defibrillator, ICD, device to control heart rhythm disorder

NI

Degenerative arthritis, inflammation of jointsP+ Mild or minimal symptoms, or seen only on x-ray; no prescription medications for this for the past 36 months, no prednisone

or cortisone treatment at any time, no surgery done or recommended; no functional limitations, no joint injections.P Mild to moderate symptoms, regular use of nonprescription medications; no joint replacements, no functional limitations,

no joint injections. S Moderate symptoms, regular use of prescription medications, no functional limitations; single non-weight-bearing joint

replacement stable 6 months acceptable.SI Moderate symptoms, no physical limitations, no use of narcotics, treatment with injections acceptable after 6 months’ stability,

prescription medications acceptable; multiple non-weight-bearing joint replacements acceptable.SII Moderate symptoms, mild physical limitations, occasional use of narcotics; other prescription medications acceptable.NI With more than mild physical limitations; surgery anticipated, surgery completed within the past 6 months; regular narcotic

use; need for assistive devices.

Dementia, all forms, mental confusion, memory loss, cognitive impairment NI

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Depression, mental disorder of altered mood

Preferred Plus• Stable for 36 months controlled with one medication.• May be situational or chronic.• No bipolar disorder.• No functional impairment from any cause.• No history of hospitalizations or ER visits for mental illness.• No history of ECT (electro convulsive therapy, electric shock therapy).• Does not interfere with daily activities or work.

Preferred• Stable for 12 months, controlled with one medication.• May be situational or chronic.• No bipolar disorder.• No functional impairment from any cause.• No history of hospitalizations or ER visits for mental illness.• No history of ECT (electro convulsive therapy, electric shock therapy).• Does not interfere with daily activities or work.

Standard/Select I/Select II:• May require multiple medications to manage.• Well-controlled bipolar or manic depressive disease stable 48 months.• No hospitalizations or ER visits in the past 72 months.• No history of ECT.• No cognitive or functional impairment.

Not Insurable: • Severe disease.• History of multiple hospitalizations.• Multiple medication adjustments within the last 24 months.• Any history of ECT.• Any indication of functional or cognitive impairment.

Dermatomyositis, chronic weakness and inflammation of musclesNI

Diabetes mellitus, impaired sugar metabolismP Mild, including the isolated diagnosis “hyperglycemia” without diabetes; average Hgb A1C < 7.0, controlled with diet only;

otherwise good health, nonsmoker for more than 5 years, none of the comorbid conditions listed under “NI”.S Mild, average Hgb A1C < 7.0, controlled with diet, otherwise good health, nonsmoker, none of the comorbid conditions listed

under “NI”.SI Mild, average Hgb A1C 7.1 – 8.0, none of the comorbid conditions listed under “NI;” controlled with oral medications

for < 10 years; with elevated blood pressure readings or taking blood pressure medications.SII Mild to moderate, nonsmoker for 2 or more years, average A1C 8.1 – 9.0, use of oral anti-diabetic medications; with elevated

blood pressure readings, or taking blood pressure medications.NI • Insulin use.

• Average Hgb A1C > 9.0.• Coronary artery disease.• Cerebrovascular disease, CVA, TIA.• Hypertension (unless very mild, and well controlled). • Atrial fibrillation.• Current smoker. • Peripheral vascular disease (PVD).• Peripheral neuropathy.• Nephropathy, kidney damage.• Albuminuria. • Retinopathy, eye damage.

Dialysis, kidney, or renal dialysis, process of mechanically removing metabolic wastes from the blood NI

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Disabled, collecting disability benefits, worker’s compensation, or Social Security disability payments except possibly for blindness

NI

Diverticulitis/diverticulosis, pouching, or bulging of the intestines, may be infectedP+ Incidental imaging diagnosis; or mild, recovered, no hospitalizations.P, S Mild to moderate symptoms, controlled, stable 6 months; or any brief hospitalizations within past 36 months with

stable recovery.SI, SII Moderate, fully-controlled, stable; any hospitalizations in past 36 months, but no hospitalizations in past 12 monthsNI Severe flare within past 24 months requiring more than brief hospitalization, but no surgery done; or 3 or more flares.

within past 24 months; or surgery anticipated, recommended, or scheduled.

Dizziness, vertigo, sensation of spinning, lightheadedness, weakness, unsteadiness, loss of balanceP+ 24 months’ stability; episodic, fully investigated, serious condition ruled out, benign cause, no functional limitations,

no related falls.P 3 months’ stability; occasional insignificant dizziness only; no functional limitations; no related falls; serious condition

ruled out.P Labyrinthitis or vestibulitis diagnosis firmly established; imaging scan negative for central nervous system disease;

non-progressive; no functional limitations; no related falls; 24 months’ stability.S Labyrinthitis or vestibulitis diagnosis firmly established; imaging scan negative for central nervous system disease;

non-progressive; no functional limitations; no related falls, 6 months’ stability.SI Meniere’s disease as above, except no imaging studies done.SII 12 months’ stability; associated single fall without injury; without coexisting neurological or vascular symptoms.NI Current dizziness or vertigo; cause of symptoms unknown; evaluation in progress.

Drug dependency or abuse, chronic compulsive dependence on a substance that produces adverse physical and psychological consequences

P In recovery > 60 months, good health, stable; no severe multi-drug or IV drug dependency.S In recovery > 36 months, good health, stable; no severe multi-drug or IV drug dependency.SI In recovery > 36 months, related health conditions well-controlled, stable.NI In recovery less than 36 months, or any relapses in recovery period, or continued use.

E - GEmphysema, COPD, chronic obstructive pulmonary disease, chronic obstruction of airway passages in the lungs

P Mild disease, nonsmoker; FEV1 greater than 65%.S Moderate disease, nonsmoker; FEV1 50 - 65%.IC Mild disease, continued smoking with FEV1 greater than 65%.NI Severe, or FEV1 less than 50%.

Endarterectomy, surgical treatment of carotid artery diseaseSI 12 months’ stability after surgery, no TIA, no stroke, nonsmoker, surgery on one side only.SI 36 months’ stability after surgery on one side only; if TIA prior to surgery.SII 24 months’ stability after surgery on one side only, nonsmoker, with any other health conditions that are well controlled

and not listed under “NI”.NI Bilateral endarterectomy, TIA or stroke; recurring or residual stenosis of vessel(s); symptomatic with any degree of

stenosis; current smoker, or past smoker in most recent 24 months; with diabetes, with any type of atrial fibrillation;moderate or severe heart valve disease; history of heart attack; angina; arterial thrombosis; arterial embolism; peripheralvascular disease; claudication; unstable blood blood pressure.

Endocarditis, inflammation of lining of the heartS Recovered without complications, no residual heart damage, full exercise tolerance, 12 months’ stability.S Recovered with only complication being stable mild residual valve disease, heart damage; 48 months’ stability, full

exercise tolerance.SI 12 months’ stability with recovery and mild residual heart valve disease, full exercise tolerance.SII 36 months’ stability, recovery with moderate residual heart valve disease, full exercise tolerance.NI Related to prosthetic device, multiple episodes, cardiac symptoms, or with residual moderate to severe heart damage.

Epilepsy, seizure disorder, chronic disorder of brain wave activity that causes intermittent seizuresP 24 months’ stability, well-controlled on medications, no associated cognitive or functional limitations.S 12 months’ stability, well-controlled on medications, no cognitive or functional limitations.NI Seizure within past 12 months, poor control, seizure of unknown cause, and/or any residual associated cognitive or

functional limitations.

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Epstein-Barr syndrome, infectious mononucleosis, chronic viral infectionP, S Full recovery, 6 months’ stability, no hospitalization, no residual splenomegaly known; no residual fatigue.SI, SII Full recovery, hospitalization more than 6 months ago, spleen involvement resolved.NI Recent infection within past 6 months, or ongoing symptoms or residual effects.

Esophageal varices, chronic obstruction of blood flow of the esophagus related to liver functionNI

Esophagitis, GERD, or gastro-esophageal reflux disease symptoms of heartburn P+ Symptoms controlled with diet and/or medication, no stricture of esophagus.P Ongoing mild to moderate symptoms, no more than mild stricture of esophagus, stable 24 months.

Falls, reason for the fall(s) will be underwrittenP+ Single fall, 24 months’ stability, with minor or no injury; no fractures, not associated with dizziness; no gait disturbance; no

need for assistive devices for ambulation; no TIA or stroke.P Single fall in past 12 months, with no injury or fracture; not associated with dizziness, or gait disturbance, or TIA;

no assistive devices.S Two falls with minor or no injury; last one more than 24 months ago, cause identified, treated and resolved; no need for

assistive devices.SI 1 or 2 falls, minor injury, no fractures, cause of fall has been treated and resolved, stable 12 months; no assistive devices.SII More than 2 falls without injury, last one more than 12 months ago, cause identified, treated, resolved; no need for

assistive devices. NI Multiple falls including within the past 12 months, with fractures, or need for assistive devices.

Fibromyalgia, chronic condition with fatigue and widespread muscle and joint pain P+ Fully recovered 48 months, no limitations, no treatment.P Fully recovered, 24 months’ stability. S Mild symptoms treated with nonprescription medications; 36 months’ stability.SI Moderate symptoms, 36 months’ stability, use of prescription medications, no functional limitations, no narcotic use.SII 24 months’ stability, moderate symptoms, use of prescription medications, no functional limitations.NI Severe symptoms, or recent onset within past 24 months, or use of narcotics for this condition, or with any

functional limitations. Fuch’s corneal dystrophy, congenital condition of the eye

SI One eye involved, with corneal transplant, no visual impairment, 24 months’ stability.SII One eye involved, with corneal transplant, no visual impairment, 12 months’ stability.SII One eye involved, without corneal transplant, 36 months’ stability.NI Both eyes involved; corneal transplant being considered within next 36 months, corrected visual acuity worse than 20/40

in best eye.

Gallbladder, cholecystitis, cholelithiasis, inflammation of, or stones in the gallbladder P+ Stones present, incidental finding, no symptoms; or after surgery with no complications, and 3 months’ stability. P 12 months’ stability, stones present, single flare of symptoms, no surgery done.S 24 months’ stability, 1 or 2 past episodes of symptoms, or with mild cholecystitis, stable with no current symptoms.IC All others.

Gastric bypass surgery, surgical procedure for decreasing absorption of nutrients from the small intestine; used to treat obesityP 48 months’ stability, no complications of liver problems, vitamin deficiencies or malabsorption; weight stable; no diabetes,

no cardiac disease, no joint disease of hips, knees, back.S 24 months’ stability, no complications of liver problems, vitamin deficiencies or malabsorption; weight stable; no vitamin

deficiencies or malabsorption; no diabetes, no cardiac disease, no joint disease of hips, knees, back.SI 24 months’ stability, any complications have resolved and remained stable; weight stable, no diabetes, no cardiac disease;

mild joint disease acceptable; any hypertension if well-controlled.SII 24 months’ stability, any complications have resolved and remained stable, no diabetes, minimal joint symptoms,

well-controlled hypertension, build stable.SII 36 months’ stability after any complications have been resolved and remained stable; well-controlled diabetes with

Hgb A1C < 7.0; minimal joint symptoms, no hypertension; build stable.NI Any complications including liver problems/abnormalities, vitamin deficiencies or malabsorption; dumping syndrome,

anemia, vitamin deficiency, or liver problems; with arteriosclerotic heart disease or cardiomyopathy, moderate to severe jointdisease of hips, knees, or back; poorly controlled blood pressure.

Gastro-esophageal reflux disease (GERD), esophagitis, symptoms of heartburn P+ Symptoms controlled with diet and/or medication; no stricture of esophagus.P Ongoing mild to moderate symptoms, no more than mild stricture of esophagus, stable 24 months.

Gastrointestinal (GI) polyps, usually benign growths in the lining of the stomach and intestinesP+ Surgically removed, no further disease, no active bleeding.IC Malignant, see criteria for cancer.

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Gilles de la Tourette syndrome, Tourette’s syndrome, inherited neurological disorder, characterized by unusual, repetitious, unintentional behaviors

P Controlled, fully functional, no added psychiatric diagnosis, stable 24 months.S, SI, SII Controlled symptoms, additional neurological conditions.IC Controlled, fully functional, with any additional diagnoses. NI Poorly-controlled, untreated; or with functional or cognitive impairments.

Glaucoma, disorder of regulation of pressure within the eye; may cause loss of visionP+ Mild to moderate without visual impairment. NI Visual impairment that affects ADLs.

Goiter, enlarged thyroid gland P+ Stable with treatment.

Gout, painful joint inflammation due to crystallization of uric acid in the jointP+ Mild disease, 6 months’ stability with no acute flares of symptoms; medications of a preventive nature only.P Mild disease, preventive medication, infrequent flares; 6 months’ stability.S Moderate disease with multiple joints involved, or with mild deformity.NI Moderate to severe disease; or with regular narcotic use, or with functional limitation or assistive devices; or with kidney disease.

Guillain-Barre syndrome, GBS, “French polio,” inflammatory disorder of nerves outside the brain and spinal cord, with impairment of sensation and movement

P+ Fully recovered, no residuals, stable 24 months. P Fully recovered with no residuals, stable 12 months. S 24 months’ stability; recovered with mild residuals, no functional limitations.NI Less recovery period than noted above; with relapses, or more than mild neurological residuals.

HHashimoto’s thyroiditis, inflammation of thyroid gland

P+, P Treated and controlled. NI Untreated, or poorly controlled.

Headaches, migraine, moderate to severe throbbing pain in the head, may involve nausea and vomiting; may be worsened by light,odors, physical activity

P+, P Mild to moderate, preventive medication acceptable, 12 months’ stability.S, SI, SII Severe, occasional narcotic use acceptable (< 3 x wk).NI Regular narcotic use (> 3 x wk, ongoing).

Heart attack/myocardial infarction, MI, sudden blockage of blood flow to the muscle of the heartP Mild, stable 36 months, nonsmoker, no functional limitations, no hypertension, no stroke, TIA, atrial fibrillation; no recent

angina; no known carotid stenosis or peripheral arterial disease; placement of single stent with no subsequent angina is acceptable.

S Mild, stable 36 months, nonsmoker, no functional limitations, mild hypertension under good control, no stroke, TIA, atrial fibrillation; no recent angina; no known carotid stenosis or peripheral arterial disease; placement of single stent with no subsequent angina is acceptable.

S Mild, stable 12 months, nonsmoker, no functional limitations, no hypertension, no stroke, TIA, atrial fibrillation; no recent angina; no known carotid stenosis or peripheral arterial disease; placement of single stent with no subsequent angina is acceptable.

S1 Moderate, nonsmoker, any other conditions well controlled; no stroke, TIA, or atrial fibrillation; no recent angina, no hypertension, 24 months’ stability, acceptable with mild, non-insulin-dependent diabetes with onset of diabetes in the past 4 years with A1C average less than 7.0.

S2 Severe, stable 24 months; nonsmoker, any other conditions well controlled, no stroke, TIA, atrial fibrillation; no recent angina;blood pressure under excellent control; ECHO with ejection fraction of 45% or greater.

NI With chronic angina, chronic chest pain, poorly controlled blood pressure, smoker, or with diabetes other than the above, or with stroke, TIA, or with atrial fibrillation, or with both hypertension and diabetes.

Heart murmur, abnormal heart sound caused by partially impaired blood flow through the valvesP+ No functional limitations, no symptoms, no treatment required; any arrhythmia must be under excellent control. P, S Asymptomatic moderate murmur unevaluated; with arrhythmia not under good control. NI Unevaluated grade IV/VI, without symptoms; or with symptoms other than arrhythmia.

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Heart valve disease, dysfunction or malformation of the flow-regulators between the chambers of the heartP Mild, single valve disease, 12 months’ stability, well controlled, good exercise tolerance, no other heart disorders; no atrial fibrillation.P Single valve disease, surgically corrected with full recovery and 48 months’ stability, good exercise tolerance, no atrial

fibrillation, no other heart disorders.S Single valve disease, surgically corrected with full recovery and 12 months’ stability, good exercise tolerance, no atrial

fibrillation, no other heart disorders.S1, S2 Mild-moderate single vessel, unoperated disease, or post-replacement valve surgery, 24 months’ stability; well controlled

with medications, well controlled blood pressure, no diabetes, no stroke or TIA, no angina, no atrial fibrillation.NI Surgery recommended or planned, or with chronic atrial fibrillation, diabetes, stroke, TIA, angina, poorly controlled

blood pressure.

Hemiplegia, hemiparesis, paralysis of half of the bodyNI

Hemochromatosis, blood disorder P No known cirrhosis or other organ involvement; regular treatment with phlebotomies acceptable if labs normal after

treatment; stable 24 months.SII No known cirrhosis or other organ involvement, regular treatment, normal lab results.NI Known or suspected cirrhosis; abnormal lab results after treatment; any organ involvement.

Hemophilia, blood clotting disorderNI

Hepatitis, disorder involving inflammation of the liverP+ Hepatitis A or Hepatitis E: full recovery, no complications, stable 12 months, normal lab.s P Hepatitis B: full recovery, no complications, normal labs, stable 12 months.P History of Hepatitis C, chronic, treated, recovered, normal labs, 24 months’ stability.S Chronic carrier of hepatitis: history of Hepatitis B, chronic, normal labs, no fibrosis on recent biopsy; 24 months’ stability.NI Any type that is current, or any described as alcoholic, autoimmune, or active Hepatitis C, Hepatitis D, or any type with cirrhosis

or fibrosis of the liver.IC Others.

Herniated disc, bulge or rupture of the disk(s) between the vertebrae of the spine P+ No symptoms or medications for the past 36 months; if symptoms diagnosed as only muscle strain, 6 months stability;

no current physical therapy, no functional limitations.P Mild symptoms resolved, stable for 6 months, resolved by surgery; no functional limitations, disability, no assistive devices;

regular use nonprescription medications.S Current symptoms, no functional limitations, regular use of prescription medication, no current regular narcotic use, physical

therapy acceptable.SI Mild to moderate symptoms, no regular narcotic use, minimal functional limitations, no osteoporosisSII Mild to moderate symptoms, multiple medications, occasional narcotic use (< 3 x wk), minimal functional limitations,

no surgery recommended or planned; not receiving worker’s compensation or disability payments.NI Severe symptoms, disabling symptoms, functional limitations, regular narcotic use, surgery recommended or planned,

receiving worker’s compensation or disability reimbursement.

Hiatal hernia, protrusion of the stomach upward into the esophagusP+ Asymptomatic, or mild symptoms.P Mild to moderate with good control.NI Severe, uncontrolled symptoms, or surgery recommended or anticipated.

High blood pressure, hypertension, abnormally high pressure in the arteriesP+ Mild, controlled at no greater than 140/90 average reading, without heart disease; without diabetes; stable 24 months.P Mild, controlled with average readings no greater than 140/90, nonsmoker, no heart disease, no diabetes, stable 12 months.S Mild, controlled, stable 12 months; without diabetes; with mild stable coronary disease, average readings no greater than 140/90.S Moderate, controlled without diabetes, without heart disease, stable 12 months, with average readings no greater than 145/95.SI Moderate, control with medication(s), average readings < 145/95, may be in combination with other cardiac conditions

or diabetes if all conditions well-controlled; 6 months’ stability.SII Moderate, controlled with medication(s), average readings < 160/90, with any other conditions well controlled,

6 months’ stability.NI Poorly-controlled with average readings greater than 160/95, or together with poorly controlled diabetes, severe coronary

artery disease, stroke, TIA, atrial fibrillation, heart valve disease.

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Hip replacement, the condition for which procedure was done will also be underwrittenP+, P Single hip joint replacement, fully recovered, no functional limitations, 6 months’ stability following completion of

rehabilitation, no other joints involved; no regular use of narcotics.P, S Single hip joint replacement, 6 months’ stability from time of surgery, no complications, no functional limitations, mild

arthritis other joints, no pain with walking. S Single hip replacement completed, 6 months’ stability from time of surgery, moderate arthritis of one or more other joints, no

functional limitations; no regular use of narcotics. SI, SII Single or both hip joint(s) replacement completed, 6 months’ stability from time of surgery; moderate arthritis; or mild

functional limitations.NI Hip replacement anticipated within next 24 months, or regular use of narcotics.

HIV positiveNI

Hodgkin’s lymphoma, lymphoma, cancer of lymphatic system Stage I, successfully treated, no bone marrow transplant done.

S 36 months’ stability.SI 24 months’ stability.SII 12 months’ stability.

Stage II, successfully treated, no bone marrow transplant done.SI 36 months’ stability, successfully treated; no bone marrow transplant done.SII 24 months’ stability, successfully treated; no bone marrow transplant done.

Stage III or IV; or any stage, or with bone marrow transplant done with full recovery, or if any relapse. IC 96 months’ stability.

Home Health Care service, within previous yearNI

Huntington’s chorea, inherited disease of the nervous systemNI

Hydrocephalus, abnormal accumulation of fluid in the brain, with or without VP (ventriculo-peritoneal) shuntNI

Hyperparathyroidism, over-production of hormones of the parathyroid glandP+ Surgically corrected, full function, 12 months’ stability.P Not surgically treated; no evidence of pending surgery; lab values for calcium < 11.5; 12 months’ stability.S, I Not surgically treated; no evidence of pending surgery; 36 months’ stability, lab values for calcium always < 12.0.NI Surgery pending; or calcium levels 12.0 or greater; or with severe or untreated osteoporosis.

Hypertension, HTN, high blood pressure, elevated pressure within the arteriesP+ Mild, controlled at no greater than 140/90 average reading, without heart disease; without diabetes; stable 24 months.P Mild, controlled with average readings no greater than 140/90, nonsmoker, no heart disease, no diabetes; stable 12 months.S Mild, controlled, stable 12 months; without diabetes; with mild stable coronary disease, average readings no greater

than 140/90.S Moderate, controlled without diabetes, without heart disease, stable 12 months, with average readings no greater

than 145/95.SI Moderate, controlled with medication(s), average readings < 145/95, may be in combination with other cardiac conditions

or diabetes if all conditions well-controlled; 6 months’ stability.SII Moderate, controlled with medication(s), average readings < 160/90, with any other conditions well-controlled,

6 months’ stability.NI Poorly-controlled with average readings greater than 160/95, or together with poorly-controlled diabetes, severe coronary

artery disease, stroke, TIA, atrial fibrillation, heart valve disease.

Hyperthyroidism, over-production of hormone from the thyroid glandP+, P Without symptoms, controlled with medication, 6 months’ stability, resolved with surgery or I-131 radiation.NI Untreated, or poorly controlled, ongoing symptoms.

Hypothyroidism, under-production of hormone from the thyroid glandP+ Controlled with medications, 2 months’ stability.IC Others.NI Untreated or poorly controlled.

Hysterectomy, surgical removal of uterusP+ For non-malignant reasons, 2 months’ stability without complications.

All others will be underwritten for the condition for which the surgery was done.

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IICD, implantable cardioverter defibrillator, device to control heart rhythm disorder

NIIleostomy, surgically created opening in which a part of the bowel is brought through the abdominal wall, where waste is expelled,reason for which surgery was done will be underwritten

S 24 months after surgery, stable without complications.SI, SII 6 - 12 months post-surgery, without complications.NI On-going complications from surgery, or from condition for which the surgery was done.

Implantable cardioverter defibrillator, ICD, device to control heart rhythm disorderNI

Incontinence, fecal, leakage of bowel contentsS Stress or urge type, minimal leakage; easily managed independently; symptoms not getting worse; no medications required.SI, SII Stress or urge type, with occasional leakage; requires medications or devices to manage; non-progressive, fully independent

in care.NI Others.

Incontinence, urinary, leakage of urineP+ Urinary stress or urge type, minimal leakage, easily managed, symptoms not progressive, no medications required.P Urinary stress or urge type, with leakage, requires medications or devices to manage, non-progressive, completely

independent in care.S Urinary stress or urge type, history of corrective surgery or history of skin breakdown due to incontinence, with 6 months’

stability, use of medications or devices acceptable, independent in managing care.SI, SII Urinary incontinence any type, requires medications and/or devices to manage; history of hospitalization due to bladder

dysfunction, fully resolved, stable12 months; independent in managing care.IC 24 months’ stability, with mild, stable neurogenic bladder; no in-dwelling catheter; very well managed incontinence;

no functional limitations, noprogressive symptoms.NI Catheter use, indwelling or intermittent more than twice weekly; poorly managed incontinence; limited functional abilities;

progressive symptoms; or with any fecal incontinence.Inner ear disorder, abnormality of the structure and function of the ear

P+, P Mild, occasional medication use; rare vertigo; no falls.S Moderate, regular medication use, no associated neurological symptoms.SI, SII Moderate, with intermittent vertigo or dizziness, no falls.NI Severe, with any neurological disorders, or with multiple falls.

Intestinal angina, abdominal pain caused by narrowed or blocked blood vessel(s) to the intestinesNI

Intestinal obstruction, partial or complete obstruction of the passageway in the small or large bowelP+ One episode only, surgically corrected, no malignancy, 12 months’ stability, no ileostomy, no colostomy.P 2 or more episodes, surgically corrected, or one episode not surgically corrected, no malignancy, 24 months’ stability; Standard

rates if only 12 months’ stability; an –ostomy will be rated separately.SI, SII More than 2 episodes, not surgically corrected; 24 months’ stability.NI Surgery anticipated, or regular use of narcotics.

Irritable bowel syndrome (IBS), abnormal bowel function, alternating between constipation and diarrheaP+ Mild.P Moderate.S, SI, SII, Occasionally severe symptoms, stable; no functional impairment, no associated comorbid conditions or chronic fatigue

symptoms or fibromyalgia; 36 months’ stability.NI Severe, or surgery anticipated, poorly controlled, or with fecal incontinence.

ITP, Idiopathic thrombocytopenia purpura, blood clotting disorderP+ Fully recovered without current therapy, without splenectomy, 24 months’ stability.P Treated with splenectomy, fully recovered, no current therapy, 24 months’ stability.S Chronic, asymptomatic ITP with or without a history of splenectomy, average platelet count over previous 24 months at >

90,000; on no treatment, no counts over previous 24 months greater than 90,000.IC Intermittent use of low dose steroid therapy.NI Need for chronic, continuous steroids, or with history of CVA, TIA, or with neurological deficits, hospitalization or complications

due to ITP.

J – KKidney dialysis, process of mechanically removing metabolic wastes from the blood

NI

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Kidney infection, pyelonephritis, infection of the collecting portion of the kidneyP+ Single episode, recovered, stable 24 months, normal kidney function.P Single episode, recovered, stable 12 months, normal kidney function.S Stable 36 months, 2 episodes; recovered, normal kidney function.SI, SII Chronic infection stable 36 months, normal kidney function; no more than mild proteinuria.NI Chronic, unstable, or abnormal kidney function; more than mild proteinuria.

Kidney infection, glomerulonephritis, infection involving the filtering portion of the kidneyP+ Post-streptococcal, or other glomerulonephritis, completely resolved; normal renal function, 60 months’ stability, normal

renal function, normal urine testing.P 36 months’ stability; post-streptococcal, or other glomerulonephritis, completely resolved; function, normal renal function,

normal urine testing.S Post-streptococcal, normal renal function, 36 months’ stability.NI Abnormal renal function, or any renal failure or insufficiency.

Kidney stones (calculi), nephrolithiasis, an aggregation of mineral salts within the urinary systemP+ Resolved, single episode, without current symptoms, stable 3 months.P More than 2 episodes, treated and resolved, without current symptoms, stable 3 months.IC All others.

Kidney transplant, grafting of a living organ from one person to anotherNI

Knee replacement, removal of diseased joint, and insertion of an artificial joint in its placeP+, P Total or partial single knee joint replacement, no post operative complications, 6 months’ stability after rehabilitation

complete, no functional limitations, no other joints involved.P, S Total or partial or bilateral knee joint replacement(s), 6 months’ stability from time of surgery, no complications, no functional

limitations, mild arthritis other joints.SI, SII Total or partial single knee replacement completed, 6 months’ stability from time of surgery, moderate arthritis other joints,

mild functional limitations.NI If after 6 months from time of surgery, there are complications; or functional limitations or pain with ambulating, or if surgery

recommended or pending, or current narcotic use.

L – MLacunar infarction, lacunar infarct, a small vascular blockage deep within the brain

P Single infarct, no neurological residuals, stable 60 months.S Single small infarct, no neurological residuals, stable 24 months.SI Asymptomatic, 2 small infarcts, no neurological residuals, stable 24 months.SII Minor neurological residuals, minor functional limitations, no assistive devices; no cognitive impairment, blood pressure

controlled < 140/80; stable 24 months.NI Any history of stroke with ADL or other limitations, multiple strokes, or any CVA with high blood pressure, or with atrial

fibrillation, or with diabetes, or smoking.

Lambert-Eaton syndrome, myasthenia syndrome, a neurological disorderNI

Leukemia, malignancy of white blood cells and bone marrow CLL, chronic lymphocytic leukemia.

SI Stage 0, or Stage I; 36 months’ stability; asymptomatic; stable lab results.NI Stage II, III, or IV; with unstable blood results.

CMLL, chronic myelogenous leukemia. NI

ALL, acute lymphocytic leukemia.P 96 months’ stability; no bone marrow transplant.S 96 months’ stability, with successful bone marrow transplant done; no relapse.IC Other.

AML, acute myelogenous leukemia P 96 months’ stability; no bone marrow transplant.S 96 months’ stability, with successful bone marrow transplant; no relapse.IC Other.

Hairy cell leukemiaSI 120 months’ stability after treatment completed; no current spleen or lymph node enlargement.SII 96 months’ stability after treatment; no current spleen or lymph node enlargement; bone marrow biopsy within past

36 months with normal results.

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Lung cancer, malignancy of lungSI 96 months’ stability; surgical removal, no positive lymph nodes; no evidence of recurrence or spread of the disease;

nonsmoker for at least 60 months, 90 day elimination period (EP).IC Others.NI Positive lymph nodes; continued smoking; spread of cancer; recurrence.

Lupus, discoid, inflammatory skin disorder which can affect internal organsP Limited to skin, no other lupus symptoms; no oral steroid use; 60 months’ stability.S Limited to skin, no other lupus symptoms; no oral steroid use; 24 months’ stability.SI Limited to skin, no other lupus symptoms, no oral steroid use; 12 months’ stability.NI If diagnosed as lupus erythematosus, or systemic lupus erythematosus.

Lyme disease, infectious disease spread by deer tick, may affect jointsP+ 6 months’ stability after full recovery.P 6 months’ stability after recovery, with minimal residual effects that are well-controlled.IC < 6 months’ recovery, with current treatment, no ADL limitations.NI Symptoms poorly-controlled, with residual functional impairment, with or without current treatment.

Lymphoma, Hodgkin’s lymphoma, cancer of the lymphatic systemStage I, successfully treated, no bone marrow transplant done.

S 36 months’ stability.SI 24 months’ stability.SII 12 months’ stability.

Stage II, successfully treated, no bone marrow transplant done.SI 36 months’ stability, successfully treated; no bone marrow transplant done.SII 24 months’ stability, successfully treated; no bone marrow transplant done.

Stage III or IV; or any stage, or with bone marrow transplant done with full recovery, or if any relapse. IC 96 months’ stability.

Macular degeneration, progressive degeneration of the retina of the eyeP+ 12 months’ stability, without vision impairment.P 60 months’ stability, with mild vision impairment.NI Progressive or moderate visual impairment or ADL dependency.

Malignant melanoma, serious type of skin cancerP Very early stage, completely removed, 48 months’ stability.S Very early stage, completely removed, 24 months’ stability.S With any recurrence; with any positive lymph node, 120 months’ stability.SI, SII Early stage, completely removed, 48 months’ stability.NI, IC With recurrence; with positive lymph nodes.

Manic depression, bipolar disorder, a mental illness of extreme mood swings which can be disablingS Well-controlled on medication; a single hospitalization more than 10 years ago acceptable; fully independent, no cognitive or

functional limitations; 48 months’ stability.SI 36 months’ stability; well-controlled on medication; a single hospitalization more than 10 years ago acceptable; fully

independent, no cognitive or functional limitations.SII 24 months’ stability; well-controlled on medication; a single hospitalization more than 120 months ago acceptable; fully

independent, no cognitive or functional limitations.NI Multiple psychiatric hospitalizations; any cognitive or functional impairment; multiple medication adjustments in past

48 months; hospitalization within past 120 months.

Medicaid recipient, an individual receiving funding from a government agency for medical expensesNI

Memory loss, confusion, dementia, cognitive disorderNI

Meniere’s disease, sudden severe attacks of dizziness or vertigoP 24 months’ stability, not progressive, no functional limitations, controlled with medications.S 24 months’ stability, not progressive; rare falls; no functional limitations; controlled with medication.NI With evidence of coexisting neurological problems, vascular disorder, strokes, hospitalizations, or frequent falls.IC Other.

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Mental retardation, disorder of below-average mental functioningNI

Mitral valve prolapse, ineffective closure of the valve between the left chambers of the heartP+, P Mild to moderate, without symptoms, no other cardiac conditions. S 24 months’ stability with surgically replaced valve, no other significant cardiac conditions.IC Others.NI With other cardiac conditions including atrial fibrillation, CVA, stroke, TIA, or other valve disease.

Multiple myeloma, cancer of white blood cellsNI

Multiple sclerosis, all types, progressive disease of nerve fibers of brain and spinal cordNI

Muscular dystrophy, genetic disease of progressive loss of muscle functionNI

Myasthenia gravis, neurological disorder with muscle weakness P+ 60 months’ stability, resolved with thymectomy or other therapy; no symptoms, off all treatment for 36 months.SI, SII 60 months’ stability; ocular myasthenia only; well-controlled, stable on one medication.

Myelodysplasia, myelodysplastic syndrome, bone marrow disorderNI

Myocarditis, inflammation of heart muscleP+ History of single episode, complete recovery, no underlying heart disease, no arrhythmia, no congestive heart failure,

no heart-related symptoms, off all heart-related medication, 36 months’ stability. P History of single episode, complete recovery, no underlying heart disease, no arrhythmia, no congestive heart failure, no

heart-related symptoms, off all heart-related medication, 24 months’ stability.S Complete recovery, no other heart disease, no arrhythmia; off all heart-related medications; 12 months’ stability. NI History of myocarditis with CHF; with serious arrhythmia; or with functional impairmen.t

Myocardial infarction, MI, heart attack, sudden blockage of blood flow to the muscle of the heartP Mild, stable 36 months, nonsmoker, no functional limitations, no hypertension, no stroke, TIA, atrial fibrillation; no recent

angina; no known carotid stenosis or peripheral arterial disease; placement of single stent with no subsequent angina is acceptable.

S Mild, stable 36 months, nonsmoker, no functional limitations, mild hypertension under good control, no stroke, TIA, atrial fibrillation; no recent angina; no known carotid stenosis or peripheral arterial disease; placement of single stent with no subsequent angina is acceptable.

S Mild, stable 12 months, nonsmoker, no functional limitations, no hypertension, no stroke, TIA, atrial fibrillation; no recent angina; no known carotid stenosis or peripheral arterial disease; placement of single stent with no subsequent angina is acceptable.

S1 Moderate, nonsmoker, any other conditions well-controlled; no stroke, TIA, or atrial fibrillation; no recent angina, no hypertension, 24 months’ stability, acceptable with mild, non-insulin-dependent diabetes with onset of diabetes in the pastfour years with A1C average less than 7.0.

S2 Severe, stable 24 months, nonsmoker, any other conditions well-controlled, no stroke, TIA, atrial fibrillation; no recent angina,blood pressure under excellent control; ECHO with ejection fraction of 45% or greater.

NI With chronic angina, chronic chest pain, poorly controlled blood pressure, smoker, or with diabetes other than the above, or with stroke, TIA, or with atrial fibrillation, or with both hypertension and diabetes.

N – QN – QNarcolepsy, disabling neurological disorder of sleep regulation

P 36 months’ stability, well-controlled, independent in ADLs, no functional or cognitive impairment, no falls or accidents. S 24 months’ stability, well-controlled, independent in ADLs, no functional or cognitive impairment, no falls or accidents.NI Poorly-controlled; with any functional or cognitive impairment.

Narcotic use, use of a category of drugs that depress the function of the central nervous system; the condition for which this is usedwill also be underwritten

IC Occasional use for any condition; “occasional” is < 3 pills per week.NI Regular use for any condition; “regular” is > 3 pills per week.

Nephrolithiasis, kidney stone, an aggregation of mineral salts within the urinary systemP+ Single episode, resolved, without current symptoms, stable 3 months.P+ Two episodes, treated and resolved, without current symptoms, stable 24 months.P More than 2 episodes, no current symptoms, stable 36 months.NI Current symptoms.

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Nephrosclerosis, hardening of kidney tissueNI

Nephrotic syndrome, progressive kidney damage NI

Neurogenic bladder loss of normal urinary bladder function due to a disorder of the nerves that affect the bladderSII 24 months’ stability; mild condition; no incontinence; no catheterization needed.NI Progressive disease, more than moderate symptoms; daily incontinence; daily catheterization needed.

Neuropathy, peripheral neuropathy, numbness, tingling of part of the body due to nerve disorder; most common in feet and hands

P Mild numbness of fingers or feet; fully functional; non-progressive or improved, 60 months’ stability; no weakness, no diabetes, no narcotic use.

S Mild numbness of feet or fingers; fully functional; non-progressive; no weakness, no diabetes, 12 months’ stability.S Peripheral nerve injury or entrapment; minimal or no residual functional impairment; no surgery recommended or planned;

24 months’ stability; no more than mild stable, or improving weakness; no diabetes, no narcotic use.NI Major symptoms, or use of narcotics, or with impaired function, or if due to diabetes; any symptoms that are progressive.

Nursing home confinement, current or in past 12 monthsNI

Organ transplant, except cornea, grafting of living tissue from one person to anotherNI

Organic brain syndrome (OBS) chronic disease or injury that interferes with brain function NI

Osteomyelitis, infection involving bone tissueP+ Single bone involvement, fully resolved with no functional limitations, no diabetes; 24 months’ stability.P Single bone involvement; fully resolved and stable for 12 months; no diabetes; no functional limitations.P Single bone involvement; recurrent episodes fully resolved; no diabetes; no functional limitations; 48 months’ stability.S Recurrent episodes, single bone involvement, no functional limitations, 12 months’ stability, no diabetes.NI Any active infection current; single or multiple episodes due to chronic illness, including diabetes; or with residual deficits.

Osteoarthritis, OA, arthritis, inflammation of joint(s)P+ Mild or minimal symptoms, or seen only on x-ray; no prescription medications for this for the past 36 months, no prednisone

or cortisone treatment at any time, no surgery done or recommended; no functional limitations, no joint injections.P Mild to moderate symptoms, regular use of nonprescription medications; no joint replacements, no functional limitations;

4 or fewer steroid or other joint injections in the past 24 months acceptable. S Moderate symptoms, 6 months’ stability; regular use of nonprescription medications acceptable, treatment with steroid and

other joint injections acceptable; no functional limitations; with one or more joint replacements.SI Moderate symptoms, no physical limitations, no use of narcotics, treatment with injections acceptable after 6 months’ stability,

prescription medications acceptable; multiple non-weight-bearing joint replacements acceptable.SII Moderate symptoms, mild physical limitations, occasional use of narcotics; other prescription medications acceptable.NI With more than mild physical limitations; surgery anticipated, surgery completed within the past 6 months; regular narcotic

use; need for assistive devices.Osteoporosis, condition of decreased bone tissue

P Mild disease, stable 24 months, asymptomatic, no history of falls, no fractures, using at least one corrective medication or supplement, bone mineral density (BMD) results in T scores average better than –3.0, nonsmoker, no falls or fractures.

S Moderate disease, stable 24 months, asymptomatic, no history of falls, no fractures, treated with medication or supplements, average BMD scores better than –3.5; nonsmoker, no falls or fractures.

SI Mild to moderate disease, treated with medication or supplements, smoker, no falls or fractures, average BMD T scores better than –3.5.

SII Moderate disease, treated with medication or supplements, smoker, a single BMD T score of –4.5, with overall T score averagebetter than –3.5.

NI Severe symptoms, with or without functional limitations; use of assistive devices; underweight; condition untreated; anyhistory of falls or fractures; BMD T scores less favorable than –4.5.

Ovarian cancer, cancer of the ovary, malignancy of the ovariesNegative lymph nodes, surgically treated, no recurrence:

P 60 months’ stability.S 36 months’ stability.

Positive lymph nodes, surgically treated, no recurrence:P 96 months’ stability.S 60 months’ stability.SI, SII 48 months’ stability.NI Others.

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Oxygen use, supplemental therapy to increase oxygen availability for the bodyNI

Pacemaker, device implanted in the body to regulate heartbeat; the condition for which this device is needed will also be underwritten

P 24 months’ stability after placement, clinical conditions stable, asymptomatic; no ongoing cardiac arrhythmia; no syncope orpre-syncope after placement.

S 12 months’ stability; asymptomatic clinical conditions; no ongoing serious cardiac arrhythmia after placement; no syncope orpre-syncope after placement.

S1, S2 24 months’ stability; other clinical conditions stable; no ongoing serious cardiac arrhythmia after placement; no syncope orpre-syncope after placement.

NI Any ongoing cardiac arrhythmia, after placement or procedure, any symptoms of syncope (fainting) or pre-syncope (near-fainting).

Paget’s disease of bone, bones become enlarged, weakened and deformedP Localized, no symptoms, no bone pain, no fracture, no neurologic symptoms, no limitations, 12 months’ stability.S More than local skeletal involvement but not extensive; no associated symptoms or fractures; lab tests, i.e. alkaline

phosphotase, stable; 24 months’ stability.SI More than local skeletal involvement but not extensive; no associated symptoms or fractures; lab tests stable;

12 months’ stability.NI Marked extensive bone involvement; progressively rising lab tests; greater than minimal bone discomfort; with bone

deformity, or any associated pathological fracture; any neurological involvement; any associated functional limitation. Pancreatitis, inflammation of pancreas

P+ If due to gallstone disease; no history of excessive alcohol use; one or two episodes; completely resolved; 36 months’ stability.P One episode, idiopathic; no history of excessive alcohol use; stable 36 months.S One episode, idiopathic; no history of excessive alcohol use; stable 24 months.SI One episode, idiopathic; no history of excessive alcohol use, stable 12 monthsSII One or two episodes resulting from alcohol abuse, if no current alcohol use, 60 months’ stability.NI More than two episodes or chronic pancreatitis.

Paralysis, weakness, or lameness of part of the body SI 48 months’ stability; weakness or paralysis of one upper extremity due to trauma; active without functional impairment.SII 48 months’ stability; weakness or paralysis of one lower extremity due to trauma; active without functional impairment,

single brace acceptable.NI More than one extremity, and others.

Parkinson’s disease, progressive condition affecting balance, coordination, ability to walk and ability to swallowNI

Pericarditis, inflammation of the sac around the heartP+ 24 months’ stability after single episode, no other heart disease, completely resolved; no underlying autoimmune disorder or

tuberculosis suspected.P 12 months’ stability; after single episode, no other heart disease, completely resolved.IC All others; rating will depend on extent and severity of episode.

Peripheral neuropathy, numbness, tingling of part of the body due to nerve disorderP Mild numbness of fingers or feet; fully functional; non-progressive or improved, 60 months’ stability; no weakness,

no diabetes, no narcotic use.S Mild numbness of feet or fingers; fully functional; non-progressive; no weakness, no diabetes, 12 months’ stability.S Peripheral nerve injury or entrapment; minimal or no residual functional impairment; no surgery recommended or planned;

24 months’ stability; no more than mild stable, or improving weakness; no diabetes, no narcotic use.NI Major symptoms, or use of narcotics, or with impaired function, or if due to diabetes; any symptoms that are progressive.

Peripheral vascular disease (PVD), disease of blood vessels of arms and legsP 6 months’ stability; mild, asymptomatic, not surgically treated; nonsmoker, no diabetes, no heart disease, no other vascular

disease, no CVA, stroke, TIA, skin ulcers, no current or past gangrene or amputation. S 6 months’ stability; moderate disease, not surgically treated; no smoking, no heart disease, CVA, stroke, TIA, or additional

vascular disease; no skin ulcers, no current of past gangrene; no amputation.NI Current symptoms (claudication), or any surgical treatment; or with smoking, diabetes, heart disease, CVA, stroke, TIA,

additional vascular disease, skin ulcers, or with current or past gangrene, or with amputations.

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Phlebitis, DVT, deep vein thrombosis, venous statis, venous stenosis, blood clot, or stagnation of blood; the cause will beunderwritten as well

P+ Single episode, with precipitation identifiable cause such as trauma or surgery; successfully treated, complete recovery; 24 months’ stability.

P Single episode, with precipitation identifiable cause such as trauma or surgery; successfully treated, complete recovery; 6 months’ stability.

S More than one episode, cause known, successfully treated, complete recovery, 36 months’ stability.SI More than one episode, cause known, successfully treated, complete recovery, 24 months’ stability.SII Inferior vena cava filter or umbrella surgically placed; no subsequent clotting events; 60 months’ stability.

Physical therapy, a medically directed program of improving musculoskeletal movementP+ No functional impairment, no regular narcotic use, no assistive devices, no prescription medications other than

non-steroidal anti-inflammatory drugs (NSAIDs), 6 months’ stability.P No functional impairment, no regular narcotic use, no assistive devices, no prescription medications other than

non-steroidal anti-inflammatory drugs (NSAIDs), < 6 months’ stability.S Minimal functional impairment, no ADL limitations, no assistive devices, no regular narcotic use, no prescription

medications (other than NSAIDS), no functional limitations.SI, SII Minimal functional impairment, no ADL limitations, no regular narcotic use, prescription medications acceptable;

3 months’ stability.NI Moderate functional impairment, need for assistive devices, any ADL limitations, need for assistive devices.

Pick’s disease, a form of dementia with onset of symptoms usually prior to age 60NI

Polycystic kidney disease, genetic disorder with progressive kidney failurePolycythemia vera, p.vera, disorder of bone marrow

IC Hemoglobin controlled within normal range, asymptomatic, 120 months’ stability.NI Others.

Polymyalgia rheumatica (PMR), disorder of muscles of shoulders and hipsP Controlled without steroids, stable 12 months.S Controlled with low dose steroids (< 5 mg prednisone per day); symptoms improving; no functional limitations;

stable 12 months. NI Any functional limitations, or complications from steroid use, or any ADL or IADL dependencies, or need for

assistive devices.Post-polio syndrome, muscle weakness that occurs several years after acute paralytic poliomyelitis

IC, usually NI History of past poliomyelitis, post-polio symptoms, or recent increasing fatigue, or history of shortness ofbreath, 36 months’ stability after resolution of symptoms.

Pregnancy, gestational process of growth and development of a fetusP If currently pregnant, or if within 30 days postpartum with apparent full and uncomplicated recovery.

Prostate cancer, malignancy of the prostate glandGleason 2 - 5; tumor stage T1 or T2; no recurrence:

P 60 months’ stability, 90 day elimination period (EP).S 36 months’ stability, 90 day EP. SI 24 months’ stability, 180 day EP.SII 12 months’ stability, 180 day EP.

Gleason 6; tumor stage T1 or T2; no recurrence:P 60 months’ stability, 90 day EP. S 36 months’ stability, 180 day EP.

Gleason 7; tumor stage T1 or T2; no recurrence:S 60 months’ stability, 90 day EP.SI 36 months’ stability, if pre-treatment PSA less than 20, 180 day EP.IC Others, 48 months’ stability, 180 day EP.NI High stage/grade, hormone treatment (for example: Lupron, Eulixin).

Prostate disorders, prostatism, benign prostatic hypertrophy (BPH), enlarged prostate glandP+ BPH present, minimal symptoms, unoperated, or surgery with good results, normal PSA, 3 months’ stability.P Mild to moderate symptoms, no surgery recommended or pending; normal PSA, 6 months’ stability; past surgery

with good results.NI BPH, severe symptoms, or surgery recommended or pending; abnormal prostate exam, not worked up, or work up in

progress, pending results of exam. See guidelines for PSA readings in this guide.

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PSA, elevated, a blood test that measures prostatic specific antigen, which is a marker of abnormal prostate function P+ PSA stable <6 or trending downward. Biopsy negative. 12 months’ stability.P Abnormal PSA <6, no nodule on exam. No biopsy; 12 months’ stability. S PSA 6-10. No biopsy. No prostate nodule on exam. 12 months’ stability.IC PSA 11 - 20, without biopsy, no prostate nodule on exam; 36 months’ stability.NI PSA 11 - 20, without biopsy; no prostate nodule on exam, > 36 months’ stability; or any current PSA > 20.

Psychosis, mental disorder that generally impairs behaviorSII 60 months’ stability; single episode, fully recovered; may be on single medication; no other major mental health

comorbidities; no chronic schizophrenia.NI Other.

Pulmonary embolism, blood clot to the lung(s)P+ Single episode, with precipitation identifiable cause such as trauma or surgery; successfully treated, complete recovery;

24 months’ stability.P Single episode, with precipitation identifiable cause such as trauma or surgery; successfully treated, complete recovery;

6 months’ stability.S One or two episodes, cause known, successfully treated, complete recovery, 36 months’ stability.SI Two episodes, cause known, successfully treated, complete recovery, 24 months’ stability.SII One or two episodes with inferior vena cava filter or umbrella surgically placed; no subsequent clotting events;

60 months’ stability.SII Three or more episodes, treated with medication, stable 96 months without recurrence.

Pulmonary fibrosis, scarring of lung tissueP Incidental diagnosis on chest x-ray only, not described as diffuse.S Inactive disease, no treatment required, nonsmoker, never a smoker; not diffuse. SI Inactive disease, no treatment, current smoker, not diffuse.NI Others, or any described as idiopathic.

R – ZRestless legs syndrome, movement disorder involving painful sensations in legs during periods of inactivity or rest

P+ Mild symptoms, controlled on medication(s), no functional impairment; 12 months’ stability.P Moderate symptoms, controlled on medication(s) with no functional impairment; 12 months’ stability.S Moderate symptoms, controlled on medication(s) with no functional impairment; 6 months’ stability.NI Severe symptoms; or with any functional limitations.

Retinitis pigmentosa, progressive degeneration of the retina of the eyeNI

Retinopathy, disorder of the retina of the eyeIC Due to causes other than diabetes (cause will also be underwritten).NI Due to diabetes.

Rheumatoid arthritis, chronic inflammatory autoimmune disease, primarily of joints but can involve internal organs and tissuesP Mild, controlled with mild anti-inflammatories, stable 12 months, no functional limitations, no assistive devices.S Moderate, controlled with one medication, no steroid use, stable 1 year; no functional limitations, no assistive devices.SI, SII Moderate, controlled with multiple medications, history of one joint replacement stable 12 months, no functional

limitations, no assistive devices.NI Physical limitations, history of multiple joint replacements, or anticipated surgery, any functional limitations or

assistive devices.Sarcoidosis, inflammatory disease that begins in lungs; may involve other organs

P+ Full recovery presumed but without x-ray, no residual disease, 36 months’ stability.P 6 months’ stability; full recovery presumed but without x-ray, no residual disease.S 12 months’ stability; Stage I, no limitations, normal PFTs, active lifestyle.SI 36 months’ stability; Stage II, no limitations; occasional use of inhaled steroids acceptable; active lifestyle, no abnormal PFTs.NI Stage III-IV disease; persistent diffuse disease, or progressive disease; or with multiple organ involvement; and/or involvement

of heart or central nervous system; or with any hospitalization required; or current treatment with oral steroids required.Schizophrenia, disabling brain disorder

NIScleroderma, autoimmune disorder of connective tissue

NISclerosing cholangiitis, progressive disorder of gall bladder, liver, and bile ducts

NI

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Seizure disorder, epilepsy, chronic disorder of brain wave activity that causes intermittent seizuresP+ 60 months’ stability, no associated cognitive or functional limitations.P 24 months’ stability, well-controlled on medications, no associated cognitive or functional limitations.S 12 months’ stability, well-controlled on medications, no cognitive or functional limitations.NI Seizure within past 12 months, poor control, seizure of unknown cause.

Shunts in brain, heart, or kidney, an artificial passage to divert fluids within the body (not the same as a ‘stent’)NI

Shy-Drager syndrome, progressive disorder of nervous system NI

Sjogren’s syndrome, autoimmune disorder, may be associated with rheumatoid arthritisP Mild symptoms of eyes and mouth, no steroid or immunosuppressive treatment, no functional limits, no organ involvement,

12 months’ stability.S Moderate to severe symptoms of eyes and mouth, require regular attention; no functional limits, no organ involvement, no

evidence of progression, 12 months’ stability.NI Progressive disease, or any organ involvement.

Skin cancer, basal cell or squamous cell cancersP+ Up to 4 basal cell or squamous cell lesions removed, without complications.P+ Other recurrences, or moderate stage, or recurrence, none for 48 months.P Other recurrences, or moderate stage, none for 24 months.P Single recurrence, early stage, within 12 months.S Frequent recurrence, but none for 24 months.IC Others (for malignant melanoma, see criteria in this guide).

Sleep apnea, brief cessation of breathing during sleepP Mild or moderate, controlled with medications or C-PAP; mild well-controlled hypertension acceptable.S Mild or moderate, controlled with C-PAP. Associated with mild atherosclerotic heart disease; 12 months’ stability.NI Severe, or poorly-controlled, or affects daytime functioning; mild to moderate disease associated with more than mild

hypertension or more than mild heart disease.Smoking cigarettes, behavior of smoking tobacco rolled in paper

P Without medical problems.S With chronic respiratory infections, chronic bronchitis, bronchiectasis, or with well-controlled atrial fibrillation.SI, SII With exercise intolerance; inactive pulmonary fibrosis; clinically significant COPD ruled out; FEV1 > 50%, or with

well-controlled atrial fibrillation.NI With diabetes, coronary artery disease, heart attack, MI, stroke, CVA, TIA, COPD, emphysema, severe asthma, abnormal

pulmonary function test results.Social Security Disability Insurance recipient (SSDI), an individual who is receiving funding from a government source to compensate for medical costs and lost wages.

NISpinal stenosis, narrowing of the spinal canal

P Mild or by imaging only, stable 24 months, no functional impairments or neuropathy.S Successfully treated surgically, with full recovery, no residual deficits, no functional impairment, 12 months’ stability.SI Mild to moderate symptoms, no functional impairment, no assistive devices for ambulation, no neuropathy.SII Moderate symptoms, mild neuropathy, no functional impairment, no surgery planned or recommended.NI Moderate to severe degree, functional limitations present, surgery recommended or planned.IC All others.

Stent, cardiovascular, neural, or renal; material used to hold tissue in place, or support to maintain an open blood vessel or tube to accommodate urine flow; will underwrite the primary condition

ICSteroid use, chronic, ongoing use of a type of drug used to control inflammation; will underwrite the condition for which the medication is used; the concern with chronic steroid use is the damage to bones, and to the heart. “Steroid” also known as cortisol,cortisone, or Prednisone

IC < 7.5 mg/day orally, or > 4 joint injections/yr, or > 4 taper dose “bursts” orally/yr.NI > 7.5 mg/day.

Stroke, ‘brain attack,’ sudden loss of neurological function, caused by vascular injury in the brainSI 60 months’ stability, cardioembolic stroke only (stroke caused by clot), single event, underlying cause resolved, no carotid

stenosis, no diabetes, no neurological residuals.NI Any other type of stroke (hemorrhagic), any history of stroke with ADL or other residual limitations, multiple strokes, any

stroke with high blood pressure, or with atrial fibrillation, or with diabetes, or with smoking.1If lacunar infarct, see ‘lacunar infarct’ in this impairment section

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Subarachnoid hemorrhage, bleeding between the membranes covering the brainSII Successful surgical treatment, no residual effect, no cognitive deficit, no other vascular or neurological diseases, 12 months’ stability.IC Present, unoperated.NI Within 12 months, or untreated, or with other cardiovascular or neurological disorders, or cognitive impairment.

Subclavian steal syndrome, stenosis or obstruction of the blood vessel under the collarboneP+ If caused by bony compression and relieved, no functional impairment, 6 months’ stability.P If caused by bony compression, relieved with minimal current symptoms; no functional impairment; 6 months’ stability.S If due to bony compression, not resolved; mild symptoms, no functional impairment.NI Due to cardiovascular or neurological disorder(s), or with any functional impairment regardless of cause, surgery

recommended or pending.Subdural hematoma, blood clot under the membranes of the brain

P 48 months’ stability; result of an identified single episode of trauma; no suspected alcohol abuse, no residual effect, no cognitivedeficit, no other vascular or neurological diseases.

S 12 months’ stability, result of an identified single episode of trauma; no suspected alcohol abuse, no residual effect, no cognitivedeficit, no other vascular or neurological diseases.

S2 Present, unoperated, 36 months’ stability; small, asymptomatic, stable or improving. Fully functional; no other cordiovascular or neurological disorders, no cognitive impairment.

IC 36 months’ stability; present, unoperated, stable; fully functional; no other cardiovascular or neurological disorders, no cognitive impairment.

Surgery planned, a surgical procedure that is to be done in the future; will be underwritten for condition for which procedure will be done P+ 6 months’ stability from time of full recovery and being released from surgeon’s care.NI Major surgery recommended or being contemplated within 2 years, not elsewhere specified.

Syncope, fainting, temporary loss of consciousnessP+ 18 months’ stability after a single incident of syncope, work-up demonstrates no significant clinical cause, condition stable.P 48 months’ stability; result of identified single episode of trauma; no suspected alcohol abuse, successful surgical treatment,

no residual 12 months’ stability after an incident of syncope, work-up demonstrates no significant clinical cause.S 6 months’ stability, after an incident of vasovagal syncope, work-up demonstrates no significant clinical cause, condition stableSII Syncope due to cardiac arrhythmia, successfully treated with pacemaker, stable 6 months; or syncope due to non-cardiac clinical

condition, successfully treated, and resolved; 6 months’ stability.IC More than one episode of syncope and all others.

Temporal arteritis, giant cell arteritis, inflammation of arteries of brain and headP Resolved, no symptoms, off steroid treatment, no visual effects, 12 months’ stability.S Resolved, no symptoms, off steroids, no visual effects, 6 months’ stability.SI Improved symptoms, no visual effects, steroids tapered to low dose < 5 mg. daily, 12 months’ stability. IC Other. NI Currently on > 5 mg Prednisone per day; any visual symptoms, more than mild musculoskeletal symptoms.

Thromboangiitis obliterans, Buerger’s disease, inflammation of blood vessels with clottingNI

Thrombocythemia, blood clotting disorderNI

Thrombocytopenia, idiopathic thrombocytopenia purpura, ITP blood clotting disorderP+ Fully recovered without current therapy, without splenectomy, 24 months’ stability. P Treated with splenectomy, fully recovered, no current therapy, 24 months’ stability.S Chronic, asymptomatic ITP with or without a history of splenectomy, average platelet count over previous 24 months at > 90,000,

currently receiving no treatment; no platelet counts ever less than 50,000.IC Intermittent or chronic use of low dose steroid therapy; no platelet counts below 50,000.NI Need for chronic, continuous steroids, or with history of CVA, TIA, or with neurological deficits, hospitalization or complications

due to ITP.TIA, trans-ischemic attack, ‘mini-stroke’ – see below, “transient-ischemic attack”Tourette’s syndrome, Gilles de la Tourette syndrome, an inherited neurological disorder characterized by unusual, unintentional behaviors

P Controlled, fully functional, no added psychiatric diagnosis, stable 24 months.S, SI, SII Controlled symptoms, additional neurological conditions.IC Controlled, fully functional, with any additional diagnoses.NI Poorly-controlled, untreated, or with functional or cognitive impairment.

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Transient ischemic attack, TIA, ‘mini stroke,’ temporary blockage of blood flow in brain P+ Single episode, mild symptoms, without stroke, nonsmoker, no carotid stenosis, no comorbid conditions as listed below in NI.

120 months’ stability.P. Symptoms not typical for TIA, such as isolated dizziness or visual blurring, migraine or vasospasm related to birth control pills or

other causative agent strongly suspected. Diagnosis questionable. Work-up negative for embolus or atherosclerotic disease. 24 months’ stability.

S Single episode, mild symptoms, without stroke, nonsmoker, no carotid stenosis, no comorbid conditions as listed below in NI, 60 months’ stability.

NI Multiple TIAs, carotid stenosis > 50%, any that are due to vertebral-basilar artery disease, or that result from vascular surgery, anyTIA with history of stroke, smoker, diabetes, atrial fibrillation, disease of heart valve(s), coronary artery disease, heart attack, angina, thrombosis, embolism, peripheral vascular disease, claudication, or poorly controlled blood pressure.

Transplants, organ transplants, grafting of an organ from one person to another NI Organ transplants, except cornea (see criteria in this guide for corneal transplants)

Tremor, familial, benign essential tremor, benign tic disorder, “habit spasms,” uncontrolled shaking of any part of the body, mostoften hands or head

P+ Any of above conditions, fully investigated with no underlying disorder found, no impairment of function; 36 months’ stability.P Cause of tremor fully investigated with no underlying disorder diagnosed; mild impairment, fully independent; 36 months’ stability.S Cause of tremor fully investigated with no underlying disorder diagnosed; mild impairment of function, fully independent,

12 months’ stability.IC, usually NI...Other tremor disorders.

Ulcer, gastric, peptic or duodenal, lesions in lining of stomach or intestines; if with anemia, the anemia will also be underwrittenP+ Resolved without residual affects, on medications; no bleeding episodes.P Recurrent or chronic, treated with medications; no bleeding episodes.S Acute episode associated with bleeding, or anemia, 24 months’ stability.SI, SII Chronic, associated with bleeding, or with anemia, 12 months stability, treated with medication.NI Severe, chronic symptoms untreated, or surgery anticipated.

Urinary incontinence, leakage of urine P+ Urinary stress or urge type, minimal leakage, easily managed, symptoms not progressive, no medications required.P Urinary stress or urge type, with leakage, requires medications or devices to manage, non-progressive, completely independent

in care.S Urinary stress of urge type, history of corrective surgery, 6 months’ stability.SI, SII Urinary incontinence any type, requires medications and/or devices to manage, history of hospitalization due to bladder

dysfunction if fully resolved; independent in managing care, 12 months’ stability.IC With neurogenic bladder.NI Catheter use, indwelling or intermittent; poorly managed incontinence; impacts functional abilities; progressive symptoms;

fecal (bowel) incontinence.Varicose veins, enlarged blood vessels, usually of the legs

P+ Uncomplicated, without medications or treatment, no skin ulcers, no significant edema, no functional limitations.P Chronic venous insufficiency, successfully treated with surgery, 18 months’ stability, no known peripheral vascular disease,

minimal edema, no functional limitations, no ulcerations or skin breakdown after surgery.S Chronic venous insufficiency, 18 months’ stability, no surgical treatment, no functional limitations; no more than 2+ edema, no

known peripheral arterial vascular disease.SI Chronic venous insufficiency, no surgical treatment, no functional limitations, 36 months’ stability; 3+ edema; no known

peripheral arterial vascular disease.NI Skin ulcers present, or severe 4+ edema; or with cellulitis, or symptomatic peripheral arterial vascular disease or claudication.

Vertigo, dizziness sensation of spinning, lightheadedness, weakness, unsteadiness, loss of balanceP+ 24 months’ stability; episodic, fully investigated, serious condition ruled out, benign cause, no functional limitations, no related falls.P 3 months’ stability; occasional insignificant dizziness only; no functional limitations; no related falls; serious condition ruled out.P Labyrinthitis or vestibulitis diagnosis firmly established; imaging scan negative for central nervous system disease; non-progressive;

no functional limitations; no related falls; 24 months’ stability.S Labyrinthitis, vestibulitis diagnosis firmly established; imaging scan negative for central nervous system disease; non-progressive;

no functional limitations; no related falls; 6 months’ stability.SI Meniere’s disease, except no imaging studies done.SII 12 months’ stability; associated single fall without injury; without coexisting neurological or vascular symptoms.NI Current dizziness or vertigo; cause of symptoms unknown; evaluation in progress.

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Von Willebrand’s disease, blood clotting disorder P+ 60 months’ stability; no serious bleeding episodes.P 12 months’ stability; no serious bleeding episodes. IC All others.

Waldenstrom’s disease, bone marrow and blood diseaseNI

Walker use, use of a device to assist in walkingNI

Wegener’s granulomatosus, inflammation of blood vesselsP+ 60 months’ stability; clinically cured; no limitations; no significant residual lung or kidney disease.P 36 months’ stability; clinically cured; no limitations; no significant residual lung or kidney disease.IC All others.NI Currently under treatment with prednisone or Cytoxan.

Wheelchair useNI

Wilson’s disease, disorder of mineral metabolismSI, SII Stable 12 months with treatment, and normal lab results.NI Untreated, or with any liver or neurological complications.

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Policies are issued by Allianz Life Insurance Company of North America, Minneapolis, MN.

www.allianzlife.com

Allianz Life Insurance Companyof North AmericaPO Box 59060 Minneapolis, MN 55459-0060 (R-7/2006)

For agent use only – not for use by or with the public.Availability of products, features, and services may vary by state.